Ellen Florence Boudreau M.D.

NPI 1053325621 - Military Health Care Provider - 171000000X

NPI Details
NPI 1053325621
Gender Female
Enumeration Date 07/28/2006
Last Updated 12/11/2008
Entity Type Individual
Active Over 10 years ago
Practice Location
1425 PORTER ST
FORT DETRICK MD, 21702-9211, US
Phone (301) 619-4639
Fax (301) 619-2432
Business Location
1425 PORTER ST
FORT DETRICK MD, 21702-9211, US
Phone (301) 619-4639
Fax (301) 619-2432
Toxanomy
Taxonomy Code 171000000X
License State Maryland
License Number D0035540
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According to our database, Dr. Ellen Florence Boudreau M.D. NPI is 1053325621, taxonomy code is 171000000X and license number is D0035540, license state is located at Maryland. Ellen Florence Boudreau M.D. physically located at 1425 Porter St, Fort Detrick MD, 21702-9211. NPI Number Ellen Florence Boudreau M.D. has the Individual type.

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1053325621 NPI number is provided on an as is basis without warranty of any kind. 1053325621 is maintained by the National Plan & Provider Enumeration System. The contents of Ellen Florence Boudreau M.D. are for informational purposes only.