Provider Demographics
NPI:1942616982
Name:PETER W. BUTLER, M.D., ENDOCRINOLOGY, LLC
Entity type:Organization
Organization Name:PETER W. BUTLER, M.D., ENDOCRINOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-582-0011
Mailing Address - Street 1:15 STRAW AVE
Mailing Address - Street 2:SUITE 116, BROWN AREA
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-1491
Mailing Address - Country:US
Mailing Address - Phone:413-582-0011
Mailing Address - Fax:413-582-0099
Practice Address - Street 1:15 STRAW AVE
Practice Address - Street 2:SUITE 116, BROWN AREA
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1491
Practice Address - Country:US
Practice Address - Phone:413-582-0011
Practice Address - Fax:413-582-0099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-10
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA245287261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty