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:
Health care specialties
| Specialty | Code | License # | 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 13 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 | 1518939321 | NPPES |
| Connecticut | MEDICAID | 001299644 |
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