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Individual

JONATHAN DANIEL BOUCHEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1000 BLYTHE BVLD., CHARLOTTE, NC 28203
(704) 355-3641
Mailing address
1000 BLYTHE BVLD., CHARLOTTE, NC 28203
(704) 355-3641

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME147193
FL
208600000X
Surgery Physician
Primary
192308
NC

Other

Enumeration date
05/06/2013
Last updated
09/07/2022
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