MEDICARE: MELVIN L. BUTLER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	MD0000036764	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609807163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELVIN L. BUTLER M.D.

Provider Business Mailing Address
First Line	:	28 WHITE BRIDGE ROAD
Second Line	:	SUITE 208
City	:	NASHVILLE
State	:	TN
Zip	:	37205-1467
Country	:	US
Telephone Number	:	615-352-3000
Fax Number	:	615-352-6673

Provider Business Practice Location Address
First Line	:	28 WHITE BRIDGE ROAD
Second Line	:	SUITE 208
City	:	NASHVILLE
State	:	TN
Zip	:	37205-1467
Country	:	US
Telephone Number	:	615-352-3000
Fax Number	:	615-352-6673

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	11/05/2012

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