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NPI Code Detail

MEDICARE: RAMI A. BOUTROS M.D.

MEDICARE: RAMI A. BOUTROS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician30359IA

General Provider Information

NPI Number : 1063477024
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAMI A. BOUTROS M.D.
Provider Business Mailing Address
First Line : 200 HAWKINS DR
Second Line : JCP 1349
City : IOWA CITY
State : IA
Zip : 52242-1007
Country : US
Telephone Number : 319-356-1375
Fax Number : 319-356-3862
Provider Business Practice Location Address
First Line : 200 HAWKINS DR
Second Line : JCP 1349
City : IOWA CITY
State : IA
Zip : 52242-1007
Country : US
Telephone Number : 319-356-1375
Fax Number : 319-356-3862
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 07/26/2011

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Directions to “ RAMI A. BOUTROS M.D.” Practice Location

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