Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Susie Boulos, MD

Individual provider Specialist · NPI 1174533145

Dr. Susie Boulos, MD is a Specialist in Memphis, Tennessee. Licensed in Tennessee. Registered with an NPI since 2006.

Licensed in
TN
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1030 Jefferson Ave
Memphis, TN 38104-2127
Phone: (901) 523-8990
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 27769 (TN)

Record details

NPI number1174533145
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 9, 2006
Last updated in NPPESJuly 8, 2007
Mailing address9355 Gresham Cv, Germantown, TN 38139-3596

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