Individual
MICHAEL STEVEN BOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 BRICK RD FL 3, MARLTON, NJ 08053-2177
(856) 355-6000
(856) 355-6731
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-6000
(856) 355-6731
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
25MA11518400
NJ
208M00000X
Hospitalist Physician
MD478494
PA
Other
Enumeration date
06/20/2019
Last updated
09/15/2022
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