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Individual

HENRY R BOUCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3333 NORTH CALVERT STREET, SUITE 400, BALTIMORE, MD 21218
(410) 554-2270
(410) 261-2726
Mailing address
3333 NORTH CALVERT STREET, SUITE 400, BALTIMORE, MD 21218
(410) 554-2270
(410) 261-2726

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
D0053525
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
61401401
BCBS
MD
01
903A
CFBCBS OF MD
MD
01
J848
CFBCBS DC
DC
Enumeration date
06/21/2006
Last updated
10/22/2008
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