Provider Demographics
NPI:1881338861
Name:MAIORANA-BOUTILIER, ABIGAIL LEONIE (MD)
Entity type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:LEONIE
Last Name:MAIORANA-BOUTILIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:ABIGAIL
Other - Middle Name:LEONIE
Other - Last Name:BOUTILIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 STANTONSBURG RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2818
Mailing Address - Country:US
Mailing Address - Phone:252-744-1111
Mailing Address - Fax:252-744-4688
Practice Address - Street 1:2100 STANTONSBURG RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2818
Practice Address - Country:US
Practice Address - Phone:252-744-1111
Practice Address - Fax:252-744-4688
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program