John Bouchard, M.D.

Individual provider Active NPI Internal Medicine Physician · Caribou, ME

NPI 1447228010 · NPPES record last updated Feb 1, 2011

Key facts

NPI
1447228010
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
011647 (ME)
Practice address
163 Van Buren Rd
Caribou, ME 04736-3567
Phone
(207) 498-3111
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
011647MEMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 011647 ME Yes

Addresses

Primary practice location

163 Van Buren Rd
Caribou, ME 04736-3567

Mailing address

PO Box 40
Caribou, ME 04736-0040
Phone (207) 498-2350

Other providers in Caribou, ME

All providers in Caribou, ME · Internal Medicine Physician in Maine

Sources for this page

Verify at the official NPI Registry.