Michael M Boustany Md Inc

LBN: Michael M Boustany Md Inc
Michael M Boustany Md Inc is an health care organization with primary practice located at 415 Morris St Ste 105, Charleston WV 25301-1840. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Surgery is the primary health care specialty. Michael M Boustany Md Inc can be contacted via phone (304) 343-7557, or through Boustany, Michael M via phone (304) 343-7557.

Contact Information

Primary practice address
415 Morris St Ste 105 Charleston WV 25301-1840
Fax: (304) 343-3441
Website:
Authorized official contact:
Name: Boustany, Michael M Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 10600 West Virginia
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 10600 West Virginia

Profile Details

NPI number 1326044710
LBN Legal business name Michael M Boustany Md Inc
DBA Doing business as
Authorized official Boustany, Michael M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 22nd, 2005
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326044710 NPPES
Ohio MEDICAID 2065901
Ohio MEDICAID 6953086900

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