Bourguignon, Paul Robert

Bourguignon, Paul Robert is an individual health care provider with primary practice located at 50 Fair Harbour Pl Suite 2C, New London CT 06320-4731. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Bourguignon, Paul Robert can be contacted via phone (860) 443-3147.

Contact Information

Primary practice address
50 Fair Harbour Pl Suite 2C New London CT 06320-4731
Fax: (860) 443-0087
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 038703 Connecticut

Profile Details

NPI number 1154372175
LBN Legal business name Bourguignon, Paul Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2006
Last updated May 8th, 2009 - about 15 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 1154372175 NPPES
Other 2V8005 HEALTHNET
Other P3418275 HEALTHNET
MEDICAID 001387035 HEALTHNET
Other 038703 HEALTHNET
Other 010038703CT03 HEALTHNET
Other 9636760 HEALTHNET

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