Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GARY BOUDREAU, LD
Active Sole ProprietorGARY BOUDREAU, LD is a 122400000X healthcare provider located in BANGOR, Maine. NPI 1467996330 is currently active in the NPPES registry. Verify at CMS.
122400000X · BANGOR, ME
Registration Details
- NPI Number
- 1467996330
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 13, 2016 (9.4876972425999 yrs)
- Last Updated
- Dec 13, 2016
- License
-
5535 (ME)
- Sole Proprietor
- Yes
Practice Information
- Address
-
12 STILLWATER AVEBANGOR, ME, 044013984Browse ME providers · Browse ZIP 04401
- Phone
- 2079416550
- Fax
- 2079733952
- Primary Specialty
-
122400000X
122400000X
Other 122400000X Providers in BANGOR, ME
| Name | Credential | NPI |
|---|---|---|
| MR. PATRICK D ALLEN | LD | 1629203385 |
| AUSTIN J CARBONE | LD | 1366677965 |
| REBECCA J CONNOR | LD | 1053546663 |
| SHERRY M BODGE | LD | 1003041609 |
| STEPHANIE R BUXTON | LD | 1396970802 |
| DR. JOSEPH S KINGSTON | ED.D; LD | 1700015526 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.