Individual
MAYA GRACE BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
795 MIDDLE ST, FALL RIVER, MA 02721-1733
(508) 674-5600
Mailing address
28 VILLAGE ST, SOUTH EASTON, MA 02375-1755
(774) 644-7972
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
PA5347
MA
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/25/2014
Last updated
12/03/2019
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