Bourgeous, Brandon Elliott

Bourgeous, Brandon Elliott is an sole proprietor health care provider with primary practice located at 788 8Th Ave Se Suite 100, Cedar Rapids IA 52401-2107. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Bourgeous, Brandon Elliott can be contacted via phone (319) 363-2682.

Contact Information

Primary practice address
788 8Th Ave Se Suite 100 Cedar Rapids IA 52401-2107
Phone: (319) 363-2682
Fax: (319) 363-1473
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 34399 Iowa

Profile Details

NPI number 1669476602
LBN Legal business name Bourgeous, Brandon Elliott
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 8th, 2005
Last updated Dec 27th, 2011 - about 14 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 1669476602 NPPES
Iowa MEDICAID 0254680

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