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Individual
JAMES J BOUTROUS
Active
Individual
JAMES J BOUTROUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301028307
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101289
PRIORITY HEALTH
MI
01
—
2406964001
CIGNA
MI
01
—
340017814
RAILROAD MEDICARE
MI
01
—
4522258
AETNA
MI
01
—
A75907
HAP
MI
Enumeration date
04/19/2006
Last updated
07/28/2008
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