Provider Demographics
NPI:1386619278
Name:BUTCHER, ELIZABETH ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANNE
Last Name:BUTCHER
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 1:1200 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1004
Mailing Address - Country:US
Mailing Address - Phone:336-832-3948
Mailing Address - Fax:252-536-2258
Practice Address - Street 1:133 PROFESSIONAL PARK
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:NC
Practice Address - Zip Code:28339-9106
Practice Address - Country:US
Practice Address - Phone:910-230-7930
Practice Address - Fax:910-230-7949
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200401036207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
198529OtherMEDCOST
NC1375COtherBC/BS OF NORTH CAROLINA
NC891375CMedicaid
6682117OtherCIGNA HEALTHCARE
6682117OtherCIGNA HEALTHCARE
NC891375CMedicaid
NC2065636Medicare PIN