NPI 1053325621

Ellen Florence Boudreau, MD

Practitioner Military Health Care Provider Columbia, MD

Practice location

Address: 6405 Cardinal Ln, Columbia, MD 21044-4020
Phone: (301) 452-7115

Registered specialties

Military Health Care Provider Primary

Other Service Providers Taxonomy 171000000X Licence D0035540 (MD)

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Registry record

NPI: 1053325621
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Jul 2006
Record last updated: 16 Jan 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.