Individual
MAXIMINA BOUTSELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20 FOLLINSBEE LN, WEST NEWBURY, MA 01985-4201
(978) 761-4606
Mailing address
216 NORTHERN BLVD, NEWBURYPORT, MA 01950-4409
(978) 761-4606
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036139315
IL
2085R0202X
Diagnostic Radiology Physician
156198
MA
2085R0202X
Diagnostic Radiology Physician
260855
NY
2085R0202X
Diagnostic Radiology Physician
MD443290
PA
2085R0202X
Diagnostic Radiology Physician
Primary
ME110153
FL
208D00000X
General Practice Physician
156198
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101290
—
MA
05
—
04916809
—
NY
05
—
30200844
—
NH
Enumeration date
07/01/2006
Last updated
12/03/2025
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