Boutselis, Alexander G
Boutselis, Alexander G is an sole proprietor health care provider with primary practice located at 550 University Blvd , Indianapolis IN 46202-5149. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Boutselis, Alexander G can be contacted via phone (317) 944-4600.Contact Information
Primary practice address
550 University Blvd
Indianapolis IN 46202-5149
Phone: (317) 944-4600
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 01046468A | Indiana |
Profile Details
| NPI number | 1831167147 |
|---|---|
| LBN Legal business name | Boutselis, Alexander G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 11th, 2006 |
| Last updated | Apr 24th, 2023 - about last year |
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 | 1831167147 | NPPES |
| Indiana | MEDICAID | 200166030 | |
| Indiana | Other | 959090045 |
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