Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 57966 | MA |
N | 111NI0900X | Internist | 57966 | MA |
N | 207RI0200X | Infectious Disease | 57966 | MA |
NPI | 1043200157 |
---|---|
Provider Name | Dr. Joan R Butterton |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2696 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3026850 | (05) | MA |
724129 | TUFTS HEALTH PLAN (01) | MA |
A66500 | (02) | |
J06713 | BCBS MA (01) | MA |