Individual
EMMANUEL BOULOUTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
637 WASHINGTON ST, DORCHESTER, MA 02124-3510
(617) 825-9660
(617) 288-7898
Mailing address
637 WASHINGTON ST, DORCHESTER, MA 02124-3510
(617) 825-9660
(617) 288-7898
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2284528
MA
Other
Enumeration date
12/11/2014
Last updated
12/11/2014
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