Provider Demographics
NPI:1538398540
Name:BUTT, SAIRA (MD)
Entity type:Individual
Prefix:
First Name:SAIRA
Middle Name:
Last Name:BUTT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 UNIVERSITY BLVD STE 2180
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5149
Practice Address - Country:US
Practice Address - Phone:317-274-8115
Practice Address - Fax:317-274-1587
Is Sole Proprietor?:No
Enumeration Date:2009-07-11
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20712207RI0200X
IN01076668A207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2174827Medicaid
MS08736507Medicaid
IN201369490Medicaid
MS302I448639Medicare PIN
IN201369490Medicaid
MS08736507Medicaid
MS302I442235Medicare PIN