Individual
MR. SCOTT EMMANUEL BOUCAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2540 WINDY HILL RD SE, MARIETTA, GA 30067-8605
(470) 644-1274
Mailing address
988 ORIOLE WAY SW, MABLETON, GA 30126-4136
(404) 697-9142
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/04/2021
Last updated
03/21/2025
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