Dr. Estephen Boutros, MD
Student in an Organized Health Care Education/Training Program in Neptune, NJ. Individual provider (NPI-1).
NPI number1063264232
StatusActive
Last updated in NPPESApr 2, 2024
Details
- NPI
- 1063264232
- Entity type
- Individual (NPI-1)
- Name
- Dr. Estephen Boutros
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 2, 2024
- Certification date
- Mar 30, 2024
- Last updated
- Apr 2, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
1945 Nj-33Neptune, NJ 07753
Phone 732-776-4448
Mailing address
1945 Nj-33Neptune, NJ 07753
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