Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0101251523 | VA |
N | 207R00000X | Internist | 0101251523 | VA |
N | 111NI0900X | Internist | 0101251523 | VA |
NPI | 1003027301 |
---|---|
Provider Name | Dr. Ahmed Tariq Butt |
First Address | Fredericksburg, VA 22401-4654 |
Second Address | Fredericksburg, VA 22401-4654 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 01/05/2012 |