Individual
DR. ANTOINE BOUSTANY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18101 LORAIN AVE, CLEVELAND, OH 44111-5612
(216) 385-6863
Mailing address
18101 LORAIN AVE, CLEVELAND, OH 44111-5612
(216) 237-5888
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
57.251393
OH
Other
Enumeration date
07/15/2021
Last updated
08/27/2022
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