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Dr. Ellen Florence Boudreau, MD
Military Health Care Provider in Columbia, Maryland
NPI 1053325621

Ellen Florence Boudreau is a Military Health Care Provider based in Columbia, MD. Ellen Florence Boudreau practices in Columbia, MD and has the professional credentials of MD. The NPI Number for Ellen Florence Boudreau is 1053325621 and holds a License No. D0035540 (Maryland).

The current practice location address for Ellen Florence Boudreau is 6405 Cardinal Ln, Columbia, MD and can be reached out via phone at 301-452-7115.

Location: 6405 Cardinal Ln, Columbia, MD, 21044-4020
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053325621
Provider Name
Ellen Florence Boudreau
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
6405 Cardinal Ln, Columbia, MD, 21044-4020
Phone Number
301-452-7115
Fax Number
Provider Enumeration Date
07/28/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
6405 Cardinal Ln
City
Columbia
State
Maryland
Zip
21044-4020
Phone Number
301-452-7115
Fax Number
person
Provider Business Mailing Address Details
Address
6405 Cardinal Ln
City
Columbia
State
Maryland
Zip
21044-4020
Phone Number
301-452-7115
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
D0035540 (Maryland)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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