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Dr. Brant Derwent Boucher, MD
Student in an Organized Health Care Education/Training Program in Harpers Ferry, West Virginia
NPI 1003557950

Brant Derwent Boucher is a Student in an Organized Health Care Education/Training Program based in Harpers Ferry, WV. Brant Derwent Boucher practices in Harpers Ferry, WV and has the professional credentials of MD. The NPI Number for Brant Derwent Boucher is 1003557950 and holds a License No. (West Virginia).

The current practice location address for Brant Derwent Boucher is 171 Taylor St, Harpers Ferry, WV and can be reached out via phone at 304-535-6343 and via fax at 304-596-2840.

Location: 171 Taylor St, Harpers Ferry, WV, 25425-3641
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003557950
Provider Name
Brant Derwent Boucher
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
171 Taylor St, Harpers Ferry, WV, 25425-3641
Phone Number
304-535-6343
Fax Number
304-596-2840
Provider Enumeration Date
04/05/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
171 Taylor St
City
Harpers Ferry
State
West Virginia
Zip
25425-3641
Phone Number
304-535-6343
Fax Number
304-596-2840
person
Provider Business Mailing Address Details
Address
171 Taylor St
City
Harpers Ferry
State
West Virginia
Zip
25425-3641
Phone Number
304-535-6343
Fax Number
304-596-2840
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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