Dr. Blaise Bourgeois, MD
Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology in Boston, MA. Individual provider (NPI-1).
NPI number1972536282
StatusActive
Last updated in NPPESAug 24, 2007
Details
- NPI
- 1972536282
- Entity type
- Individual (NPI-1)
- Name
- Dr. Blaise Bourgeois
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 9, 2006
- Last updated
- Aug 24, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology | 156598 | MA | Yes |
| 2080A0000X | Pediatrics, Adolescent Medicine | 156598 | MA |
Practice location
300 Longwood AveFegan 9
Boston, MA 02115-5724
Phone 617-355-2413 · Fax 617-730-0463
Mailing address
300 Longwood AveFegan 9
Boston, MA 02115-5724
Phone 617-355-2413 · Fax 617-730-0463
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