Provider Demographics
NPI:1629056155
Name:BOQUARD, MICHAEL JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAMES
Last Name:BOQUARD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1118 S HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-5109
Mailing Address - Country:US
Mailing Address - Phone:443-474-1517
Mailing Address - Fax:410-636-7868
Practice Address - Street 1:2401 HAWKINS POINT RD
Practice Address - Street 2:MAILSTOP 28B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21226-1797
Practice Address - Country:US
Practice Address - Phone:410-636-7506
Practice Address - Fax:410-636-7868
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2012-10-25
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Provider Licenses
StateLicense IDTaxonomies
NY157258207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine