Individual
DR. MARIAN RUTH BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
30 MOUNTAIN ST, BRISTOL, VT 05443-1310
(802) 453-4696
(802) 471-0360
Mailing address
30 MOUNTAIN ST, BRISTOL, VT 05443-1310
(802) 453-4696
(802) 471-0360
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0420008790
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OVN0681
—
VT
Enumeration date
01/31/2007
Last updated
05/01/2020
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