Provider Demographics
NPI:1609168988
Name:BULAUITAN, PHILIPPE IOANNIS (MD)
Entity Type:Individual
Prefix:
First Name:PHILIPPE
Middle Name:IOANNIS
Last Name:BULAUITAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7850 BRIER CREEK PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-8900
Mailing Address - Country:US
Mailing Address - Phone:919-578-7008
Mailing Address - Fax:919-578-4886
Practice Address - Street 1:7850 BRIER CREEK PKWY STE 220
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-8900
Practice Address - Country:US
Practice Address - Phone:919-578-7008
Practice Address - Fax:919-578-4886
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-01820207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine