MEDICARE: MUHAMMAD USMAN BUTT CRNA

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	367500000X	Certified Registered Nurse Anesthetist	10022769	OR
2	367500000X	Certified Registered Nurse Anesthetist	R0075409	OK

General Provider Information

NPI Number	:	1801040209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUHAMMAD USMAN BUTT CRNA

Provider Business Mailing Address
First Line	:	4120 S 130TH EAST AVE
Second Line	:	APT # 1113
City	:	TULSA
State	:	OK
Zip	:	74134-1132
Country	:	US
Telephone Number	:	918-814-7468
Fax Number	:

Provider Business Practice Location Address
First Line	:	4120 S 130TH EAST AVE
Second Line	:	APT # 1113
City	:	TULSA
State	:	OK
Zip	:	74134-1132
Country	:	US
Telephone Number	:	918-814-7468
Fax Number	:

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

Provider Enumeration Date	:	11/12/2008
Last Update Date	:	06/26/2024

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