Individual
DR. MARC KAMEL BOUSTANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 VOLVO PKWY STE 210, CHESAPEAKE, VA 23320-1621
(757) 261-5000
(757) 962-5610
Mailing address
725 VOLVO PKWY STE 210, CHESAPEAKE, VA 23320-1621
(757) 261-5000
(757) 962-5610
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101221457
VA
208600000X
Surgery Physician
Primary
0101221457
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007309996
—
VA
Enumeration date
06/15/2005
Last updated
02/17/2022
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