Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 828 | MN |
N | 222Z00000X | Podiatrist | 828 | MN |
N | 213E00000X | Podiatrist | N006219 | NY |
N | 222Z00000X | Podiatrist | N006219 | NY |
Y | 213E00000X | Podiatrist | SC007054 | PA |
Y | 222Z00000X | Podiatrist | SC007054 | PA |
N | 213EP1101X | Primary Podiatric Medicine | 828 | MN |
N | 213EP1101X | Primary Podiatric Medicine | N006219 | NY |
N | 111NR0200X | Radiology | 828 | MN |
N | 213ER0200X | Radiology | 828 | MN |
N | 111NR0200X | Radiology | N006219 | NY |
N | 213ER0200X | Radiology | N006219 | NY |
N | 213ES0103X | Foot & Ankle Surgery | 828 | MN |
N | 213ES0103X | Foot & Ankle Surgery | N006219 | NY |
N | 213ES0131X | Foot Surgery | N006219 | NY |
NPI | 1619065398 |
---|---|
Provider Name | Dr. Marc J Butcher |
First Address | Grove City, PA 16127-4604 |
Second Address | Grove City, PA 16127-4604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 12/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RB6092 | (02) | NY |