Michael Bourque, MD Valid NPI

Individual provider · Pediatric Surgery Physician · Hartford, CT

NPI

1518939321

Type

Individual (Type 1)

Primary specialty

Pediatric Surgery Physician (Surgery)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

2086S0120X

License number

029964 (CT)

Sex

Male

Sole proprietor

No

Enumerated

2006-02-06

Last updated

2013-11-04