Provider Demographics
NPI:1316142029
Name:BUTROS, PAUL REHA (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:REHA
Last Name:BUTROS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SELIM
Other - Middle Name:REHA
Other - Last Name:BUTROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:550 BROADVIEW AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2036
Mailing Address - Country:US
Mailing Address - Phone:540-680-3433
Mailing Address - Fax:833-448-3261
Practice Address - Street 1:550 BROADVIEW AVE STE 102
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2036
Practice Address - Country:US
Practice Address - Phone:540-680-3433
Practice Address - Fax:833-448-3261
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00885672085R0202X
VA01012607272085R0202X, 2085R0204X
MA2503182085R0202X
MN589032085R0204X
FLME1694502085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1316142029Medicaid