DIMITRIOS P BOUSOUNIS MD


Address: 200 W Silver Spring Dr Ste 255, Glendale, WI 53217-5058
Phone: 4149648450

DIMITRIOS P BOUSOUNIS MD (NPI# 1073666269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073666269
Entity Type Organization
Organization Name DIMITRIOS P BOUSOUNIS MD
Practice Address 200 W Silver Spring Dr Ste 255
Glendale
WI 53217-5058
Practice Telephone 4149648450
Practice Fax Number 4149648451
Mailing Telephone 4149648450
Mailing Fax Number 4149648451
Enumeration Date 2007-01-19
Last Update Date 2008-04-24
Authorized Official Name DR. DIMITRIOS P BOUSOUNIS (OWNER)
Authorized Official Telephone 4149648450
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM2500X Clinic/Center
Specialization: Medical Specialty
27172 WI Ambulatory Health Care Facilities

Office Location

Street Address 200 W SILVER SPRING DR STE 255
City GLENDALE
State WI
Zip Code 53217-5058

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Taxonomy Information

Taxonomy Code 261QM2500X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Medical Specialty

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Notes: [7/1/2003: new]

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Competitor

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City GLENDALE
Zip Code 53217

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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