Organization
PAIN TREATMENT CENTER ANESTHESIOLOGISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATTAS BOUTROUS II MD (PRESIDENT)
(701) 223-7822
Entity
Organization
Contact information
Practice address
202 E GREENFIELD LN STE 100, BISMARCK, ND 58503-6597
(701) 223-7822
(701) 223-7844
Mailing address
202 E GREENFIELD LN STE 100, BISMARCK, ND 58503-6597
(701) 223-7822
(701) 223-7844
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05349001
BCBS GROUP
ND
05
—
1463006
—
ND
Enumeration date
04/06/2007
Last updated
09/24/2020
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