Individual
DR. MARIA RIZKALLAH BOUSTANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
421 CARRIAGE DR, BECKLEY, WV 25801-2805
(304) 256-0242
(304) 256-0244
Mailing address
421 CARRIAGE DR, BECKLEY, WV 25801-2805
(304) 256-0242
(304) 256-0244
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
18402
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001711048
BLUE CROSS BLUE SHIELD
WV
Enumeration date
05/11/2006
Last updated
11/18/2009
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