Doctor Name: | MRS. SAMANTHA DAWN BOUCHIE |
NPI Number: | 1003131871 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | |
Business Practice Address: | 9669 E 146th St Suite 200 Noblesville, IN - 460605005 |
Business Phone Number: | 3176216300 |
Business Fax Number: | 3176216310 |
Mailing Address: | 6626 E. 75th Street, Suite 500 INDIANAPOLIS |
State: | IN |
Postal Code: | 462502890 |
Phone Number: | 3176216333 |
Fax Number: | 3176216310 |
NPI Enumeration Date: | 04/05/2010 |
NPI Last Update Date: | 03/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy 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. |