Mark P. Bouchard
Family Doctor Family Doctor - Sports Medicine
5 Bucknam Rd Suite 2c
Falmouth
, Maine 04105-1392
Mark P. Bouchard
Family Doctor Family Doctor - Sports Medicine
5 Bucknam Rd Suite 2c
Falmouth
, Maine 04105-1392
(207) 396-8632
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About
Features
Specialties
- Family Doctor
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Mark P. Bouchard
- 301c Us Route 1
- Scarborough, ME
- Zip : 04074-9701
- Fax : (207) 396-8632
- Phone : (207) 396-8600
Second Address
- Mark P. Bouchard
- 5 Bucknam Rd Suite 2c
- Falmouth, ME
- Zip : 04105-1392
- Fax : (207) 781-1507
- Phone : (207) 781-1500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Q00000X | Family Doctor | MD14613 | ME |
| N | 207QS0010X | Family Doctor - Sports Medicine | MD14613 | ME |
National Provider Identifier
| NPI | 1023040656 |
|---|---|
| Provider Name | Mark P. Bouchard |
| First Address | Scarborough, ME 04074-9701 |
| Second Address | Falmouth, ME 04105-1392 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/07/2006 |
| Last Update Date | 09/04/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 254100099 | (05) | ME |
| G62930 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.