Individual
ANTHONY MICHAEL BOULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
960 WINDHAM CT STE 1, YOUNGSTOWN, OH 44512-5087
(330) 726-3357
(330) 726-1465
Mailing address
960 WINDHAM CT STE 1, YOUNGSTOWN, OH 44512-5087
(330) 726-3357
(330) 726-1465
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35097978
OH
207RP1001X
Pulmonary Disease Physician
Primary
35097978
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126171
—
OH
Enumeration date
08/24/2009
Last updated
04/04/2024
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