Provider Demographics
NPI:1730205311
Name:BUTT, MOHAMMAD ZAMAN (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:ZAMAN
Last Name:BUTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 W 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-1901
Mailing Address - Country:US
Mailing Address - Phone:718-266-5700
Mailing Address - Fax:718-265-1590
Practice Address - Street 1:3015 W 29TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-1901
Practice Address - Country:US
Practice Address - Phone:718-266-5700
Practice Address - Fax:718-265-1590
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001301207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001301OtherNY MEDICAL LICENSE NUMBER
NY001301OtherNY MEDICAL LICENSE NUMBER