Samuel Lerush Butler, MD

Individual provider Active NPI Pulmonary Disease Physician · Verona, WI

NPI 1194377747 · NPPES record last updated Jul 14, 2019

Key facts

NPI
1194377747
Entity type
Individual (NPI type 1)
Primary specialty
Pulmonary Disease Physician 207RP1001X
License
45576-20 (WI)
Practice address
2314 Dahlk Cir
Verona, WI 53593-8846
Phone
(608) 358-1114
NPI assigned
Jul 14, 2019
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45576-20WIMDPulmonary Disease Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 45576-20 WI Yes

Addresses

Primary practice location

2314 Dahlk Cir
Verona, WI 53593-8846

Mailing address

2314 Dahlk Cir
Verona, WI 53593-8846
Phone (608) 848-3294

Other names

  • Dr. Samuel Lerush Butler Former name

Other providers in Verona, WI

All providers in Verona, WI · Pulmonary Disease Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.