Individual
DR. MICHAEL BOUCHARD II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
308 WILLOW AVE, HOBOKEN, NJ 07030-3808
(201) 418-1189
Mailing address
308 WILLOW AVE, HOBOKEN, NJ 07030-3808
(201) 418-1189
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
056-0000201
VT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2019
Last updated
08/25/2022
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