Individual
GREGORY BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
96 JONATHAN LUCAS ST, MUSC DEPARTMENT OF SURGERY, CHARLESTON, SC 29425-8900
(843) 792-3072
Mailing address
96 JONATHAN LUCAS ST, MUSC DEPARTMENT OF SURGERY, CHARLESTON, SC 29425-8900
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
LL176
SC
Other
Enumeration date
07/22/2008
Last updated
07/22/2008
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