Individual
DR. PAUL ROBERT BOURGUIGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 FAIR HARBOUR PL, SUITE 2C, NEW LONDON, CT 06320-4731
(860) 443-3147
(860) 443-0087
Mailing address
50 FAIR HARBOUR PL, SUITE 2C, NEW LONDON, CT 06320-4731
(860) 443-3147
(860) 443-0087
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
038703
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001387035
—
CT
01
—
010038703CT03
ANTHEM
CT
01
—
038703
CONNECTICARE
CT
01
—
2V8005
HEALTHNET
—
01
—
9636760
CIGNA
CT
01
—
P3418275
OXFORD
CT
Enumeration date
05/15/2006
Last updated
05/08/2009
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