Individual
DAVID BOUCHER
Active
Individual
DAVID BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G4848
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010016274
RAILROAD MEDICARE PROV NO
TX
05
—
123772901
—
TX
01
—
2060508001
CIGNA PROVIDER NUMBER
TX
01
—
72486303
UNITED HEALTHCARE PROV NO
TX
01
—
814765
BCBS PROVIDER NUMBER
TX
Enumeration date
06/16/2005
Last updated
10/06/2022
Update your record
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