Individual provider · Type 1 NPI

Susie Boulos, MD

Specialist · Memphis, TN

NPI number 1174533145 Active

Practice location

1030 Jefferson Ave
Memphis, TN 38104-2127

Call (901) 523-8990 Map

Mailing address

9355 Gresham Cv
Germantown, TN 38139-3596

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X27769 (TN)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1174533145

Susie Boulos, MD's National Provider Identifier is 1174533145, issued on Aug 9, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Memphis, TN. The record was last updated on Jul 8, 2007.