Individual
ALEXIS BOUSAMRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
320 E NORTH AVE, PITTSBURGH, PA 15212-4756
(412) 359-6886
(412) 359-3598
Mailing address
320 E NORTH AVE, PITTSBURGH, PA 15212-4756
(412) 359-6886
(412) 359-3598
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD454058
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0137384
—
OH
05
—
1030886790001
—
PA
Enumeration date
04/09/2009
Last updated
10/07/2020
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