Butlak, David Jonathan

Butlak, David Jonathan is an individual health care provider with primary practice located at 218 Old Mocksville Rd , Statesville NC 28625-1930. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Butlak, David Jonathan can be contacted via phone (704) 838-7570.

Contact Information

Primary practice address
218 Old Mocksville Rd Statesville NC 28625-1930
Phone: (704) 838-7570
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 160852 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 2690 South Carolina

Profile Details

NPI number 1881656189
LBN Legal business name Butlak, David Jonathan
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2006
Last updated Feb 28th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881656189 NPPES
South Carolina MEDICAID AN1433

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