Bourgeois, Wallace

Bourgeois, Wallace is an individual health care provider with primary practice located at 450 Brookline Ave , Boston MA 02215-5418. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology. Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology is his primary health care specialty. Bourgeois, Wallace can be contacted via phone (617) 632-2423.

Contact Information

Primary practice address
450 Brookline Ave Boston MA 02215-5418
Phone: (617) 632-2423
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 274015 Massachusetts
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology 2080P0207X 274015 Massachusetts

Profile Details

NPI number 1811317209
LBN Legal business name Bourgeois, Wallace
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 24th, 2014
Last updated Feb 22nd, 2021 - about 5 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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