| Charles a Boucher MD PC | |
|
8 Hawthorne Pl Suite 110 Boston MA 02114-2335 | |
| (617) 726-8511 | |
| (617) 742-8446 |
| Full Name | Charles a Boucher MD PC |
|---|---|
| Speciality | Internal Medicine - Cardiovascular Disease |
| Location | 8 Hawthorne Pl, Boston, Massachusetts |
| Authorized Official Name and Position | Charles Allen Boucher (PRESIDENT) |
| Authorized Official Contact | 6177268511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles a Boucher MD PC Po Box 51512 Boston MA 02205-1512 Ph: (617) 726-8511 | Charles a Boucher MD PC 8 Hawthorne Pl Suite 110 Boston MA 02114-2335 Ph: (617) 726-8511 |
| NPI Number | 1679771646 |
|---|---|
| Provider Enumeration Date | 07/10/2007 |
| Last Update Date | 07/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679771646 | NPI | - | NPPES |
| M13371 | Other | MA | BLUE CROSS BLUE SHIELD OF |
| 705823 | Other | MA | TUFTS HEALTH PLAN |
| 9738193 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 36588 (Massachusetts) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 36588 (Massachusetts) | Primary |
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