Bousounis, Dimitrios P

Bousounis, Dimitrios P is an sole proprietor health care provider with primary practice located at 200 W. Silver Spring Drive # 255, Glendale WI 53217. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology, Allopathic & Osteopathic Physicians / Clinical Neurophysiology. Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology is his primary health care specialty. Bousounis, Dimitrios P can be contacted via phone (414) 964-8450.

Contact Information

Primary practice address
200 W. Silver Spring Drive # 255 Glendale WI 53217
Phone: (414) 964-8450
Fax: (414) 964-8451
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 27172 Wisconsin
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X 27172 Wisconsin
Allopathic & Osteopathic Physicians / Clinical Neurophysiology 2084N0600X 27172 Wisconsin

Profile Details

NPI number 1861585408
LBN Legal business name Bousounis, Dimitrios P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 2nd, 2006
Last updated Oct 17th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861585408 NPPES
Wisconsin MEDICAID 30679100

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