Individual
DR. CHARLES ALLEN BOUCHER
Active
Individual
DR. CHARLES ALLEN BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36588
MA
207RC0000X
Cardiovascular Disease Physician
Primary
36588
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2064227
—
MA
01
—
705823
TUFTS HEALTH PLAN
MA
01
—
M09801
BCBS MA
MA
Enumeration date
03/15/2006
Last updated
05/05/2008
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