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

Michael M Boustany, MD

Individual provider Vascular Surgery Physician · NPI 1619973096

Michael M Boustany, MD is a General Surgery in South Charleston, West Virginia. Qualified in 1970, 56 years ago. Practices with Ths Physician Partners Inc, a 359-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in West Virginia.

Years since qualifying
56
Licensed in
WV
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

434 Division St
South Charleston, WV 25309
Phone: (304) 766-7140
Fax: (304) 766-7180
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 — (304) 414-4800

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 10600 (WV)
Vascular Surgery Physician Taxonomy 2086S0129X · Licence 10600 (WV)

Record details

NPI number1619973096
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 22, 2005
Last updated in NPPESDecember 22, 2021
Certification dateDecember 22, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 1970 (56 years in practice)
Group practice Ths Physician Partners Inc — 359 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount