Boutros, Nidal
Boutros, Nidal is an individual health care provider with primary practice located at 120 Hospital Dr Suite 300, Lebanon MO 65536-9238. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Boutros, Nidal can be contacted via phone (417) 533-6746.Contact Information
Primary practice address
120 Hospital Dr Suite 300
Lebanon MO 65536-9238
Phone: (417) 533-6746
Fax: (417) 533-6740
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2009027847 | Missouri |
Profile Details
| NPI number | 1629036173 |
|---|---|
| LBN Legal business name | Boutros, Nidal |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | Feb 10th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629036173 | NPPES |
| Missouri | MEDICAID | 1629036173 |
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