Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARK RICARD BOUDREAU JR., DO
ActiveMARK RICARD BOUDREAU JR., DO is a Pediatrics healthcare provider located in ROME, Georgia. NPI 1659834323 is currently active in the NPPES registry. Verify at CMS.
Pediatrics · ROME, GA
Registration Details
- NPI Number
- 1659834323
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 10, 2019 (7.3745059693467 yrs)
- Last Updated
- May 26, 2023
- License
-
11273 (GA)
Practice Information
- Address
-
304 SHORTER AVE NW STE 105ROME, GA, 301654256Browse GA providers · Browse ZIP 30165
- Phone
- 7062364880
- Primary Specialty
-
Pediatrics
208000000X
Other Pediatrics Providers in ROME, GA
| Name | Credential | NPI |
|---|---|---|
| ELIZABETH ANNE SMITH | M.D | 1407844624 |
| ROGENA D CORDLE | MD | 1679513360 |
| KAREN P. TIMBERLAKE | M.D. | 1891712535 |
| JAMES RUEL MCMILLIAN | M.D. | 1629090816 |
| LAURA M. DOVAN | M.D. | 1124119318 |
| DAVID MICHAEL DOHRMANN | MD | 1154481430 |
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.