# DR. ISSA M BOTROS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1124227772
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | 4301090843 | MI | — |
| 207QA0505X | Adult Medicine Physician | A106987 | CA | Yes |

## Other

- **Enumeration date:** 07/13/2007
- **Last updated:** 11/30/2021