Bourque, Michael

Bourque, Michael is an individual health care provider with primary practice located at 282 Washington St , Hartford CT 06106-3322. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Pediatric Surgery. Allopathic & Osteopathic Physicians / Pediatric Surgery is his primary health care specialty. Bourque, Michael can be contacted via phone (860) 545-9520.

Contact Information

Primary practice address
282 Washington St Hartford CT 06106-3322
Phone: (860) 545-9520
Fax: (860) 545-9545
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 029964 Connecticut
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 029964 Connecticut

Profile Details

NPI number 1518939321
LBN Legal business name Bourque, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated Nov 4th, 2013 - about 11 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 1518939321 NPPES
Connecticut MEDICAID 001299644

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