MICHAEL M BOUSTANY MD INC (NPI# 1326044710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326044710 |
| Entity Type | Organization |
| Organization Name | MICHAEL M BOUSTANY MD INC |
| Practice Address |
415 Morris St Ste 105 Charleston WV 25301-1840 |
| Mailing Address |
Po Box 3850 Charleston WV 25338-3850 |
| Practice Telephone | 3043437557 |
| Practice Fax Number | 3043433441 |
| Mailing Telephone | 3042339314 |
| Mailing Fax Number | 3042330265 |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MICHAEL M BOUSTANY (OWNER) |
| Authorized Official Telephone | 3043437557 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 208600000X | Surgery | 10600 | WV | Allopathic & Osteopathic Physicians |
| X | 2086S0129X |
Surgery Specialization: Vascular Surgery |
10600 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2065901 | 05 | |
| KY | 6953086900 | 05 |
| Street Address |
415 MORRIS ST STE 105 |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25301-1840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306382460 | Joanne Marie Torres | Physician Assistant | 415 Morris St, Suite 400, Charleston, WV 25301-1842 | 2017-01-13 |
| 1396120531 | Wesley J. Massey | Nurse Practitioner | 415 Morris St, Suite 201, Charleston, WV 25301-1842 | 2015-07-29 |
| 1033591656 | Rebecca M Bowe | Nurse Practitioner | 415 Morris St, Suite 400, Charleston, WV 25301-1842 | 2015-06-19 |
| 1164801676 | Erik James Anderson | Physician Assistant | 415 Morris St, Suite 400, Charleston, WV 25301-1842 | 2015-05-29 |
| 1780001487 | Integrated Health Care Providers, Inc. | Ophthalmology | 415 Morris St, Suite 100, Charleston, WV 25301-1842 | 2014-03-20 |
| 1386998680 | Chelsea Elizabeth Walker | Physician Assistant | 415 Morris St, Suite 201, Charleston, WV 25301-1842 | 2012-11-08 |
| 1518210046 | Natalie F. Allen | Nurse Practitioner | 415 Morris St, Suite 201, Charleston, WV 25301-1842 | 2012-10-22 |
| 1346591468 | Jacquelin L. Mollohan | Nurse Practitioner | 415 Morris St, Suite 201, Charleston, WV 25301-1842 | 2012-09-28 |
| 1275888323 | Heather Renee Conway | Nurse Practitioner | 415 Morris St, Suite 400, Charleston, WV 25301-1842 | 2012-07-16 |
| 1528351665 | Sharon Lynn Woods | Nurse Practitioner | 415 Morris St, Suite 100, Charleston, WV 25301-1842 | 2011-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087680 | Kerrie Rena Harris | Counselor | 16 Leon Sullivan Way Suite 300, Charleston, WV 25301 | 2020-09-15 |
| 1285123471 | Burgess Dental | Dentist | 405 Capitol Street, The Parlor Suite, Charleston, WV 25301 | 2018-05-03 |
| 1104322320 | Kara Caldwell | Psychologist | 333 Laidley St., 4'th Floor East, Charleston, WV 25301 | 2018-04-05 |
| 1740638022 | Christina Phalen | Pharmacy Technician | 701 Lee Street East, Charleston, WV 25301 | 2016-05-27 |
| 1366867079 | Brooke Powell Garnes | Speech-Language Pathologist | 1313 Quarrier Street, Suite A, Charleston, WV 25301 | 2014-03-04 |
| 1952648404 | Implanted Pump Management, LLC | Home Infusion | 311 Laidley St., Suite 202, Charleston, WV 25301 | 2013-01-03 |
| 1730435108 | Chaitanya Mishra | Internal Medicine | 501 Morris St Ste 357, Charleston, WV 25301 | 2012-08-03 |
| 1033477278 | James Stephen Harman | Neurological Surgery | 415 Morris St Ste 400, Charleston, WV 25301 | 2012-04-25 |
| 1265674329 | Howard and Howard Dental LLC | Dentist | 1321 Virginia St., Charleston, WV 25301 | 2009-04-03 |
| 1881856144 | Steven David Hollosi | Emergency Medicine | 501 Morris St., Charleston, WV 25301 | 2008-06-27 |
| Find all providers in zip 25301 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881219137 | Meredith Elizabeth Taylor | Surgery | 96 Jonathan Lucas St # 613, Charleston, SC 29425-8900 | 2020-06-12 |
| 1477114569 | Justin Robert Silverman | Surgery | 169 Ashley Avenue, Room 202 Muh, Msc 333, Charleston, SC 29425 | 2019-06-28 |
| 1104485648 | Gregory Tyler Rives | Surgery | 96 Jonathan Lucas St Csb 423-a / Msc 613, Charleston, SC 29425-0001 | 2019-06-09 |
| 1336633569 | Lytani Wilson | Surgery | 96 Jonathan Lucas St # 423, Charleston, SC 29425 | 2018-06-20 |
| 1609360890 | Alicia Marie Stafford | Surgery | 169 Ashley Avenue Rm 202 Main Hospital, Msc333, Charleston, SC 29425 | 2018-06-20 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1740639491 | Kiandra Scott | Surgery | 1049 Greenhill Rd, Charleston, SC 29412-5314 | 2016-06-03 |
| 1548653892 | Parinya Taupradist | Surgery | 1909 Woodside Cir, Charleston, WV 25314-2255 | 2015-03-11 |
| 1972916013 | Sarah Bennett Starosta | Surgery | 420 96 Jonathan Lucas St., Clinical Sciences Building Suite 420, Charleston, SC 29425 | 2014-06-06 |
| 1881034726 | James Philip Davies | Surgery | 3 Sawgrass Rd, Charleston, SC 29412-2522 | 2013-06-25 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25301 |
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| 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.