Provider Demographics
NPI:1962121137
Name:BUTLER, SHEILA TERICE
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:TERICE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 WILLOWBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1412
Mailing Address - Country:US
Mailing Address - Phone:810-282-6380
Mailing Address - Fax:
Practice Address - Street 1:1829 WILLOWBROOK CIR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1412
Practice Address - Country:US
Practice Address - Phone:810-282-6380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service