Individual provider · NPI-1

Mark P. Bouchard, MD

Family Medicine · Falmouth, ME

NPI number1023040656
StatusActive
Last updated in NPPESApr 9, 2020

Details

NPI
1023040656
Entity type
Individual (NPI-1)
Name
Mark P. Bouchard
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jul 6, 2006
Certification date
Apr 9, 2020
Last updated
Apr 9, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineMD14613MEYes
207QS0010X Family Medicine, Sports MedicineMD14613ME
208M00000X HospitalistMD14613ME

Practice location

5 Bucknam Rd
Suite 2c
Falmouth, ME 04105-1392

Phone 207-781-1500 · Fax 207-781-1507

Mailing address

301c Us Route 1
Scarborough, ME 04074-9701

Phone 207-396-8600 · Fax 207-396-8632

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