Organization
DIMITRIOS P BOUSOUNIS MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIMITRIOS P BOUSOUNIS MD (OWNER)
(414) 964-8450
Entity
Organization
Contact information
Practice address
200 W SILVER SPRING DR STE 255, GLENDALE, WI 53217-5058
(414) 964-8450
(414) 964-8451
Mailing address
200 W SILVER SPRING DR STE 255, GLENDALE, WI 53217-5058
(414) 964-8450
(414) 964-8451
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
27172
WI
Other
Enumeration date
01/19/2007
Last updated
04/24/2008
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