Provider Demographics
NPI:1588790646
Name:BUTLER, ERIK S (DO)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:S
Last Name:BUTLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 MANNING DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-6119
Mailing Address - Country:US
Mailing Address - Phone:984-974-0210
Mailing Address - Fax:919-966-6126
Practice Address - Street 1:590 MANNING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-6119
Practice Address - Country:US
Practice Address - Phone:984-974-0210
Practice Address - Fax:919-966-6126
Is Sole Proprietor?:No
Enumeration Date:2007-02-25
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-01746207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5907639Medicaid
NC5907639Medicaid
NC2403674Medicare PIN
NCP00687522Medicare PIN