Boutrous, James J

Boutrous, James J is an individual health care provider with primary practice located at 20952 E 12 Mile Rd Suite 200, St Clair Shores MI 48081-3200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Boutrous, James J can be contacted via phone (586) 771-4820.

Contact Information

Primary practice address
20952 E 12 Mile Rd Suite 200 St Clair Shores MI 48081-3200
Phone: (586) 771-4820
Fax: (586) 771-6620
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 4301028307 Michigan

Profile Details

NPI number 1487619722
LBN Legal business name Boutrous, James J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Jul 28th, 2008 - about 16 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 1487619722 NPPES
Michigan Other 101289 PRIORITY HEALTH
Michigan Other 4522258 PRIORITY HEALTH
Michigan Other A75907 PRIORITY HEALTH
Michigan Other 340017814 PRIORITY HEALTH
Michigan Other 2406964001 PRIORITY HEALTH

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