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NPI Code Detail

MEDICARE: LEONID BOUINYI M.D.

MEDICARE: LEONID BOUINYI 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
12084N0400XNeurology Physician46804020WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871564013
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEONID BOUINYI M.D.
Provider Business Mailing Address
First Line : 709 SPRING VALLEY RD
Second Line :
City : BURLINGTON
State : WI
Zip : 53105-7614
Country : US
Telephone Number : 262-767-6020
Fax Number : 262-767-6023
Provider Business Practice Location Address
First Line : 709 SPRING VALLEY RD
Second Line :
City : BURLINGTON
State : WI
Zip : 53105-7614
Country : US
Telephone Number : 262-767-6020
Fax Number : 262-767-6023
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2006
Last Update Date : 11/24/2021

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