Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 0101046588 | VA |
N | 207W00000X | Ophthalmologist | D0047865 | MD |
Y | 207W00000X | Ophthalmologist | MD19025 | DC |
NPI | 1023086592 |
---|---|
Provider Name | Melanie J Buttross |
First Address | Washington, DC 20016-4360 |
Second Address | Washington, DC 20016-4360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 16/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6375588 | (05) | VA |
B365 | CAREFIRST BCBS (01) | DC |
E88260 | (02) |