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Individual

ALEXIS C. BOUTENEFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
105 BUELL RD, LITCHFIELD, CT 06759-3006
(860) 567-9893
Mailing address
105 BUELL RD, LITCHFIELD, CT 06759-3006
(860) 567-9893

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
023370
CT
207Y00000X
Otolaryngology Physician
64523
MN
207Y00000X
Otolaryngology Physician
C158137
CA

Other

Enumeration date
06/19/2006
Last updated
03/14/2024
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