Dimitrios P Bousounis MD

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

27172 Issued in WI

Legal business name

DIMITRIOS P BOUSOUNIS MD

Practice address

200 W Silver Spring Dr Ste 255
Glendale, WI 53217-5058

Phone

(414) 964-8450

Fax

(414) 964-8451

NPI assigned

Jan 19, 2007

Last updated

Apr 24, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dimitrios P Bousounis, MDNPI 1861585408

Title

Owner

Phone

(414) 964-8450

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dimitrios P Bousounis, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Glendale, WI
  • NPI 1861585408
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1073666269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W SILVER SPRING DR STE 255",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532175058",
            "telephone_number": "414-964-8450",
            "fax_number": "414-964-8451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W SILVER SPRING DR STE 255",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532175058",
            "telephone_number": "414-964-8450",
            "fax_number": "414-964-8451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIMITRIOS P BOUSOUNIS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "BOUSOUNIS",
        "authorized_official_first_name": "DIMITRIOS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-964-8450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WI",
            "license": "27172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• B. Hal Dessel, LCSW, CADC III
• Bradley J Dexter, LPC
• Kari Lynn Di Fonzo, LCSW,
• Kayla Diesner
• Digitrace Care Services, Inc
• Divine Horizon Pmhnp Services, LLC
• Divine Wellness & Counseling, LLC
• Jasmine Dockery, PHARMD
• Steven J. Donatello, M.D.
• Leah Taylor Donovan, R.N., A.P.N.P.

• Medical Specialty Clinic/Center in Glendale, WI
• Providers in Glendale, WI by specialty
• Medical Specialty Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.