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Individual

DR. ALEXANDRE BOUCHARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5779 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5779 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000

Taxonomy

Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
41836
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
445688
AZ
Enumeration date
07/28/2009
Last updated
08/31/2009
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