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Individual
DR. MICHAEL BOULOUS
Active
Individual
DR. MICHAEL BOULOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01086907A
IN
2085R0204X
Vascular & Interventional Radiology Physician
Primary
01086907A
IN
Other
Enumeration date
04/01/2019
Last updated
07/14/2025
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