Individual
ANDREW BRADLEY BOUCHER
Active
Individual
ANDREW BRADLEY BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
29063
MS
207T00000X
Neurological Surgery Physician
Primary
62615
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07507017
—
MS
05
—
Q065607
—
TN
Enumeration date
04/08/2014
Last updated
11/12/2021
Update your record
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