Individual
DR. EDWARD DAVID BOUDREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
615 W 5TH ST N, CHEYENNE WELLS, CO 80810
(719) 767-5661
(719) 767-5098
Mailing address
PO BOX 578, CHEYENNE WELLS, CO 80810-0578
(614) 805-9595
(719) 451-3423
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0063534
CO
207Q00000X
Family Medicine Physician
DR.0063534
CO
Other
Enumeration date
05/25/2006
Last updated
04/06/2026
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