Bourquard, William Sullivan

Bourquard, William Sullivan is an sole proprietor health care provider with primary practice located at 6148 N Discovery Way Ste 100, Boise ID 83713-0201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bourquard, William Sullivan can be contacted via phone (208) 322-5437.

Contact Information

Primary practice address
6148 N Discovery Way Ste 100 Boise ID 83713-0201
Phone: (208) 322-5437
Fax: (208) 322-4638
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M5223 Idaho

Profile Details

NPI number 1568451193
LBN Legal business name Bourquard, William Sullivan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 17th, 2005
Last updated May 19th, 2022 - about 4 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 1568451193 NPPES
Idaho MEDICAID 003597000
Idaho Other 000010006127
Idaho Other 52233

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