Boulos, Michael

Boulos, Michael is an individual health care provider with primary practice located at 7250 Clearvista Dr Ste 120, Indianapolis IN 46256-4640. He recently has only one registered license in Allopathic & Osteopathic Physicians / Critical Care Medicine, which is considered as his primary health care specialty. Boulos, Michael can be contacted via phone (317) 621-5676.

Contact Information

Primary practice address
7250 Clearvista Dr Ste 120 Indianapolis IN 46256-4640
Phone: (317) 621-5676
Fax: (317) 621-5678
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 01054000A Indiana

Profile Details

NPI number 1083618581
LBN Legal business name Boulos, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Nov 25th, 2014 - about 11 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 1083618581 NPPES
Indiana MEDICAID 200420800A
Indiana Other P01214629

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