Individual
DR. GLEN MICHAEL BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
40 WRIGHT ST, PALMER, MA 01069-1138
(413) 284-5308
(413) 284-5413
Mailing address
280 CHESTNUT ST, 2ND FLOOR, SPRINGFIELD, MA 01199-1619
(413) 794-5700
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
000446
CT
207P00000X
Emergency Medicine Physician
Primary
78416
MA
Other
Enumeration date
02/28/2006
Last updated
12/10/2015
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