MEDICARE: GREGORY BUTLER, MD, PC.

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	207W00000X	Ophthalmology Physician	MD30132	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G8170001	OTHER	DC	CAREFIRST
2	P00059551	OTHER	DC	RAILROAD
3	2099146	OTHER	DC	UNITEDHEALTHCARE
4	385082	OTHER	DC	MAMSI
5	MD30132	OTHER	DC	STATE MEDICAL LICENSE
6	4115071	OTHER	DC	CIGNA

General Provider Information

NPI Number	:	1750477600
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGORY BUTLER, MD, PC.

Provider Business Mailing Address
First Line	:	1647 BENNING RD NE
Second Line	:	SUITE 205
City	:	WASHINGTON
State	:	DC
Zip	:	20002-4569
Country	:	US
Telephone Number	:	202-397-2800
Fax Number	:	202-397-1304

Provider Business Practice Location Address
First Line	:	1647 BENNING RD NE
Second Line	:	SUITE 205
City	:	WASHINGTON
State	:	DC
Zip	:	20002-4569
Country	:	US
Telephone Number	:	202-397-2800
Fax Number	:	202-397-1304

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. GREGORY A. BUTLER
Credential	:	M.D.
Telephone Number	:	202-397-2800

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	03/07/2023

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