Individual
NADER BOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 E MOUNTAIN DR, WILKES BARRE, PA 18711-0027
(570) 808-7762
(570) 808-6128
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 808-7762
(570) 808-6128
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD492526C
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8777306
—
NJ
Enumeration date
07/28/2006
Last updated
12/30/2025
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