Bouder, T. Glen

Bouder, T. Glen is an individual health care provider with primary practice located at 1840 Amherst St , Winchester VA 22601-2808. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Bouder, T. Glen can be contacted via phone (540) 536-8874.

Contact Information

Primary practice address
1840 Amherst St Winchester VA 22601-2808
Phone: (540) 536-8874
Fax: (540) 536-7847
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X MD051542L Pennsylvania
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 0101244705 Virginia

Profile Details

NPI number 1043203318
LBN Legal business name Bouder, T. Glen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2005
Last updated May 28th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043203318 NPPES
Maryland MEDICAID 1043203318

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