Individual
TIMOTHY BOUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1840 AMHERST ST, WINCHESTER, VA 22601-2808
(540) 536-7087
Mailing address
2531 GOLDENFIELD LN, WINCHESTER, VA 22601-6433
(804) 564-6036
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
0101248936
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669586152
—
VA
05
—
3810019813
—
WV
Enumeration date
08/19/2006
Last updated
03/29/2021
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