Individual
CAROLE BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2451 FILLINGIM ST, PATHOLOGY, MOBILE, AL 36617-2238
(251) 471-7790
(251) 471-7715
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 471-7790
(251) 471-7715
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
16509
AL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
16509
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000024061
—
AL
05
—
00118221
—
MS
01
—
11-10270
UNITED HEALTHCARE
AL
05
—
1523593
—
LA
05
—
255587500
—
FL
01
—
51024061
BCBS
AL
Enumeration date
05/10/2006
Last updated
12/03/2015
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