T. Glen Bouder
Pulmonary Disease Critical Care Medicine
1840 Amherst St
Winchester
, Virginia 22601-2808
T. Glen Bouder
Pulmonary Disease Critical Care Medicine
1840 Amherst St
Winchester
, Virginia 22601-2808
(540) 536-0235
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About
Features
Specialties
- Critical Care Medicine
- Pulmonary Disease
Languages spoken
- English
Location
First Address
- T. Glen Bouder
- 220 Campus Blvd Ste 100
- Winchester, VA
- Zip : 22601-2896
- Fax : (540) 536-0235
- Phone : (540) 536-5100
Second Address
- T. Glen Bouder
- 1840 Amherst St
- Winchester, VA
- Zip : 22601-2808
- Fax : (540) 536-7847
- Phone : (540) 536-8874
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RC0200X | Critical Care Medicine | 0101244705 | VA |
| N | 207RP1001X | Pulmonary Disease | MD051542L | PA |
National Provider Identifier
| NPI | 1043203318 |
|---|---|
| Provider Name | T. Glen Bouder |
| First Address | Winchester, VA 22601-2896 |
| Second Address | Winchester, VA 22601-2808 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/08/2005 |
| Last Update Date | 28/05/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1043203318 | (05) | MD |
| G35983 | (02) | PA |
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.