Michael Ray Bourne MD

NPI 1164412649 - Podiatrist - 213E00000X

NPI Details
NPI 1164412649
Gender Male
Enumeration Date 10/25/2005
Last Updated 01/04/2011
Entity Type Individual
Active Over 11 years ago
Practice Location
1500 CURVE CREST BLVD W
STILLWATER MN, 55082-6040, US
Phone (651) 439-1234
Fax (651) 439-1547
Business Location
1500 CURVE CREST BLVD W
STILLWATER MN, 55082-6040, US
Phone (651) 439-1234
Fax (651) 439-1547
Toxanomy
Taxonomy Code 213E00000X
License State Wisconsin
License Number 746
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According to our database, Dr. Michael Ray Bourne MD NPI is 1164412649, taxonomy code is 213E00000X and license number is 746, license state is located at Wisconsin. Michael Ray Bourne MD physically located at 1500 Curve Crest Blvd W, Stillwater MN, 55082-6040. NPI Number Michael Ray Bourne MD has the Individual type.

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1164412649 NPI number is provided on an as is basis without warranty of any kind. 1164412649 is maintained by the National Plan & Provider Enumeration System. The contents of Michael Ray Bourne MD are for informational purposes only.