Gamal S Boutros MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

33487 Issued in SC

Legal business name

GAMAL S BOUTROS MD

Doing business as

BriarCliffe Neurology

Practice address

605 Briarwood Dr
Suite E
Myrtle Beach, SC 29572-6734

Phone

(843) 427-4828

Fax

(843) 427-4689

NPI assigned

Aug 9, 2011

Last updated

Aug 9, 2011By 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. Gamal S Boutros, M.D.

Title

Owner

Phone

(843) 427-4828

Specialties & licenses 1

Addresses

Other names 1

• BriarCliffe Neurology Doing business as

Locations

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1467731406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 BRIARWOOD DR",
            "address_2": "SUITE E",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295726734",
            "telephone_number": "843-427-4828",
            "fax_number": "843-427-4689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 BRIARWOOD DR",
            "address_2": "SUITE E",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295726734",
            "telephone_number": "843-427-4828",
            "fax_number": "843-427-4689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAMAL S BOUTROS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "BOUTROS",
        "authorized_official_first_name": "GAMAL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-427-4828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "33487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BriarCliffe Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Korey Gallagher
• Christopher Galton, LPC
• Michael P Gambacorta, FNP
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• Christine Laura Gamble, M.D.
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• Lena Gammel

• Specialist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.