Individual
DR. MARK SAMIR BOUTROS
Active
Individual
DR. MARK SAMIR BOUTROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101265722
VA
207R00000X
Internal Medicine Physician
01070720A
IN
207R00000X
Internal Medicine Physician
247040
TN
207R00000X
Internal Medicine Physician
88883
SC
Other
Enumeration date
08/22/2006
Last updated
07/23/2026
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