NPI 1043388788

Jose Antonio Bouffard, MD

Practitioner Nuclear Imaging & Therapy Physician Detroit, MI

Practice location

Address: 261 Mack Ave Room 215, Detroit, MI 48201-2417
Phone: (313) 966-2539
Fax: (313) 993-2630

Registered specialties

Nuclear Imaging & Therapy Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207UN0902X Licence 4301044748 (MI)

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Registry record

NPI: 1043388788
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Dec 2006
Record last updated: 8 Sep 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.