Individual
BENJAMIN PAUL BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
811 COX RD, GASTONIA, NC 28054-3453
(704) 272-3578
Mailing address
225 BALDWIN AVE, CHARLOTTE, NC 28204-3109
(704) 376-1605
(704) 335-8448
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
2020-04025
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871723411
—
NC
Enumeration date
07/16/2009
Last updated
04/23/2024
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