Zeidan, Boutros

Zeidan, Boutros is an sole proprietor health care provider with primary practice located at 315 Locust St Suite 5B, Johnstown PA 15901-1651. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Zeidan, Boutros can be contacted via phone (814) 535-2030.

Contact Information

Primary practice address
315 Locust St Suite 5B Johnstown PA 15901-1651
Phone: (814) 535-2030
Fax: (814) 535-2031
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD064590L Pennsylvania

Profile Details

NPI number 1043204134
LBN Legal business name Zeidan, Boutros
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 6th, 2005
Last updated Jan 12th, 2011 - about 13 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 1043204134 NPPES
Pennsylvania Other 161817 HIGHMARK BLUE SHIELD
Pennsylvania Other 99630 HIGHMARK BLUE SHIELD
Pennsylvania Other 1507228 HIGHMARK BLUE SHIELD
Pennsylvania MEDICAID 0017225930005 HIGHMARK BLUE SHIELD

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