Provider Demographics
NPI:1326897133
Name:BUTKA, INES (MD)
Entity type:Individual
Prefix:
First Name:INES
Middle Name:
Last Name:BUTKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:135 QUINCY AVE APT 412
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-6737
Mailing Address - Country:US
Mailing Address - Phone:774-312-3951
Mailing Address - Fax:
Practice Address - Street 1:3401 NORTH BROAD STREET
Practice Address - Street 2:DEPT OF PATH & LAB MED - RM.B243,OPB
Practice Address - City:PHILADELPHIA, PA 19140
Practice Address - State:PA
Practice Address - Zip Code:19140
Practice Address - Country:US
Practice Address - Phone:215-707-4353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT230817207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology