Individual
KATAY C BOUTTAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
827 E KING ST, KINGS MOUNTAIN, NC 28086-3186
(704) 734-4550
(704) 734-4540
Mailing address
PO BOX 96860, CHARLOTTE, NC 28296-6860
(704) 734-4550
(704) 734-4540
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2006-00155
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903516
—
NC
Enumeration date
05/20/2006
Last updated
06/02/2025
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