Bourassa, David M
Bourassa, David M is an individual health care provider with primary practice located at 450 Clinton Street , Woonsocket RI 02895. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bourassa, David M can be contacted via phone (401) 767-4100.Contact Information
Primary practice address
450 Clinton Street
Woonsocket RI 02895
Phone: (401) 767-4100
Fax: (401) 235-6894
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD09354 | Rhode Island |
Profile Details
| NPI number | 1215992870 |
|---|---|
| LBN Legal business name | Bourassa, David M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 18th, 2006 |
| Last updated | Mar 29th, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215992870 | NPPES |
| Rhode Island | MEDICAID | 7005698 |
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