Thomas Bourke M.D.

NPI 1922117902 - General Practice - 208D00000X

NPI Details
NPI 1922117902
Gender Male
Enumeration Date 08/30/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
615 S NEW BALLAS RD
SAINT LOUIS MO, 63141-8221, US
Phone (314) 251-6031
Fax
Business Location
555 N NEW BALLAS RD
SUITE 150
SAINT LOUIS MO, 63141-6825, US
Phone (314) 991-8200
Fax (314) 991-8206
Toxanomy
Taxonomy Code 208D00000X
License State Missouri
License Number 29534
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According to our database, Thomas Bourke M.D. NPI is 1922117902, taxonomy code is 208D00000X and license number is 29534, license state is located at Missouri. Thomas Bourke M.D. physically located at 615 S New Ballas Rd, Saint Louis MO, 63141-8221. NPI Number Thomas Bourke M.D. has the Individual type.

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1922117902 NPI number is provided on an as is basis without warranty of any kind. 1922117902 is maintained by the National Plan & Provider Enumeration System. The contents of Thomas Bourke M.D. are for informational purposes only.