Individual
MR. DONALD FRANCIS BOUCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17 WATERHOUSE LN, CHESTER, CT 06412-1267
(860) 526-4333
(860) 526-4333
Mailing address
17 WATERHOUSE LN, GOLDSTAR MEDICAL SERVICES, INC., CHESTER, CT 06412
(860) 526-4333
(860) 526-4333
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12DME0363CT02
ANTHEM BLUE CROSS CT
CT
01
—
GO376254
BLUE CROSS/SHIELD MA
CT
Enumeration date
10/10/2007
Last updated
10/10/2007
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