Provider Demographics
NPI:1649292269
Name:BOUIER, ARTHUR I JR (DO)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:I
Last Name:BOUIER
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27207 LAHSER RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-2168
Mailing Address - Country:US
Mailing Address - Phone:248-967-3200
Mailing Address - Fax:248-967-1387
Practice Address - Street 1:27207 LAHSER RD
Practice Address - Street 2:SUITE 250
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-2168
Practice Address - Country:US
Practice Address - Phone:248-967-3200
Practice Address - Fax:248-967-1387
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101007369207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101007369OtherMEDICAL LICENSE
MIMI8203OtherGROUP PTAN
MI11OF304160OtherBCBS PIN
MI471738075OtherTAX ID
MIMI8203001OtherPROVIDER PTAN
MI4396374Medicaid
5631212OtherBCBS
5631212OtherBCBS
MI4396374Medicaid