Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 83826 | GA |
N | 2086S0127X | Trauma Surgeon | 83826 | GA |
NPI | 1104060144 |
---|---|
Provider Name | Caroline Butler |
First Address | Atlanta, GA 30303-3050 |
Second Address | Atlanta, GA 30303-3050 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2009 |
Last Update Date | 21/10/2019 |