Individual
NADER BOUSHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD423454
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03155608
—
NY
Enumeration date
10/19/2005
Last updated
10/19/2011
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