Individual
DR. CHERIF BOUTROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 ENGLE ST STE 6501, ENGLEWOOD, NJ 07631-1808
(201) 608-2800
Mailing address
350 ENGLE ST STE 6501, ENGLEWOOD, NJ 07631-1808
(201) 608-2800
(410) 787-4846
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
25MA12203300
NJ
2086X0206X
Surgical Oncology Physician
D0070965
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034615200
—
MD
05
—
0997579
—
NJ
01
—
238612
JOHNS HOPKINS HEALTHCARE
MD
01
—
967368-02
CAREFIRST RENDERING NUMBER
MD
01
—
GROUP PTAN:DQ7486
MEDICARE RAIL ROAD
MD
01
—
P00893238
MEDICARE RAIL ROAD
MD
01
—
Q818-0022
CAREFIRST GROUP
MD
Enumeration date
07/06/2007
Last updated
09/27/2024
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