Provider Demographics
NPI:1730250150
Name:BOUDREAUX, MARGARET (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:
Last Name:BOUDREAUX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:763 PEACHTREE PKWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-9351
Mailing Address - Country:US
Mailing Address - Phone:678-208-2050
Mailing Address - Fax:678-208-2051
Practice Address - Street 1:763 PEACHTREE PKWY
Practice Address - Street 2:SUITE 2
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-9351
Practice Address - Country:US
Practice Address - Phone:678-208-2050
Practice Address - Fax:678-208-2051
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044172208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics