Individual
MICHAEL S BOUTET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHS
Contact information
Practice address
555 BATAVIA PIKE, CINCINNATI, OH 45244-1556
(513) 772-1555
Mailing address
555 BATAVIA PIKE, CINCINNATI, OH 45244
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669438115
—
OH
Enumeration date
03/19/2014
Last updated
03/17/2018
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