Individual
DR. ANGELA HAYES-BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3120 JOHNSON FERRY RD, MARIETTA, GA 30062-5657
(770) 835-4741
(678) 401-6672
Mailing address
3120 JOHNSON FERRY RD, MARIETTA, GA 30062-5657
(708) 354-7417
(678) 401-6672
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
050762
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257244396F
—
GA
Enumeration date
10/18/2005
Last updated
10/06/2019
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