Individual
ATTAS BOUTROUS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
202 E GREENFIELD LN STE 100, BISMARCK, ND 58503-6597
(701) 223-7822
(701) 223-7844
Mailing address
202 E GREENFIELD LN STE 100, BISMARCK, ND 58503-6597
(701) 223-7822
(701) 223-7844
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
6635
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0040053
—
MT
05
—
1462491
—
ND
05
—
3537218-00
—
MN
05
—
5700930
—
SD
Enumeration date
04/06/2007
Last updated
09/24/2020
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