Provider Demographics
NPI:1699090654
Name:BOITEAU, GUILLAUME (MD)
Entity type:Individual
Prefix:DR
First Name:GUILLAUME
Middle Name:
Last Name:BOITEAU
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 1:220 S HOME AVE
Mailing Address - Street 2:APT # 404
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-2844
Mailing Address - Country:US
Mailing Address - Phone:504-616-0943
Mailing Address - Fax:
Practice Address - Street 1:220 S HOME AVE
Practice Address - Street 2:APT # 404
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202-2844
Practice Address - Country:US
Practice Address - Phone:504-616-0943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT1961542085R0204X
TXN68202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology