# DANIEL R BOURQUE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1952393084
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 016161 | LA | Yes |

## Other

- **Enumeration date:** 08/16/2005
- **Last updated:** 06/20/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1345580 | — | LA |
| 01 | — | 1659688489 | GROUP NPI | LA |
| 01 | — | 1952383084 | INDIVIDUAL NPI | LA |
| 01 | — | 5DQ00 | GROUP PTAN | LA |
| 01 | — | 5L938DQ00 | INDIVIDUAL PTAN | LA |