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Contact Information

JAMES C. BOUDREAU, DPM, SC
6191 S. 108TH ST.
HALES CORNERS, WI53130
 Phone: 414-425-5140
 Fax: 414-425-7960
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JAMES C BOUDREAU DPM SC · (Female)

NPI # 1528074309
Status Active
Credentials
Entity Individual
Enumeration date 07/31/2006
Last updated 02/15/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • WI License # 349025
  • WI Medicaid 43260100
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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