Individual
MAGDY I. BOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
774 CHRISTIANA ROAD, SUITE 202 DELAWARE NEUROSURGICAL GROUP, PA, NEWARK, DE 19713
(302) 366-7671
(302) 366-7549
Mailing address
774 CHRISTIANA ROAD, SUITE 202 DELAWARE NEUROSURGICAL GROUP, PA, NEWARK, DE 19713
(302) 366-7671
(302) 366-7549
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
C10001618
DE
207T00000X
Neurological Surgery Physician
D0020406
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
441142071
RAILROAD MEDICARE
DE
Enumeration date
09/21/2006
Last updated
06/21/2010
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