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DR. SUSIE BOULOS M.D.
NPI 1174533145
Specialist in Memphis, TN

Active since August 09, 2006
1030 JEFFERSON AVE, MEMPHIS, TN 38104(901) 523-8990 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Susie Boulos M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUSIE BOULOS M.D. (NPI 1174533145) is an individual specialist in Memphis, Tennessee, licensed in Tennessee (27769) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1174533145
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameDR. SUSIE BOULOSCredential: M.D.
Location Address1030 JEFFERSON AVEMemphis, TN 38104-2127
Mailing Address9355 Gresham CvGermantown, TN 38139-3596
Phone(901) 523-8990
Sole ProprietorNo
Enumeration DateAugust 9, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1174533145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in TN · 27769
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1030 JEFFERSON AVE, Memphis, TN 38104
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS DEBORAH GERISE KARTHEISER RN
Registered Nurse (Psychiatric/Mental Health)
1030 JEFFERSON AVE
MEMPHIS, TN 38104
Shelby County (901) 523-8990
MRS. KENYETTA D. MCINTOSH-JONES LCSW
Social Worker (Clinical)
1030 JEFFERSON AVE
MEMPHIS, TN 38104
Shelby County (901) 523-8990
KELSEY A TIEMANN PHARM.D.
Pharmacist
1030 JEFFERSON AVE
MEMPHIS, TN 38104
Shelby County (901) 523-8990
PENELOPE BLAND
Pharmacist
1030 JEFFERSON AVE
MEMPHIS, TN 38104
Shelby County (901) 523-8990
DR. MAXWELL TREVOR MCCLURE PT
Physical Medicine & Rehabilitation
1030 JEFFERSON AVE
MEMPHIS, TN 38104
Shelby County (901) 523-8990
CAMEKA SHANTA MOORE RN
Registered Nurse
1030 JEFFERSON AVE
MEMPHIS, TN 38104
Shelby County (901) 523-8990
DANIELLE NICOLE TAYLOR
Pharmacy Technician
1030 JEFFERSON AVE
MEMPHIS, TN 38104
Shelby County (901) 523-8990
DR. ROBERT WOOD SMITH DDS
Dentist (General Practice)
1030 JEFFERSON AVE
MEMPHIS, TN 38104
Shelby County (901) 523-8990

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susie Boulos's NPI number?

The NPI number for Susie Boulos is 1174533145. It was assigned to this individual provider in the NPPES registry on August 9, 2006.

Where is Susie Boulos located?

Susie Boulos practices at 1030 Jefferson Ave, Memphis, TN 38104. The listed phone number is (901) 523-8990.

What is Susie Boulos's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Susie Boulos was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.