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Individual

DAVID M BOURASSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
450 CLINTON STREET, WOONSOCKET, RI 02895
(401) 767-4100
(401) 235-6894
Mailing address
171 SERVICE AVENUE, WARWICK, RI 02886
(401) 767-4100
(401) 235-6899

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD09354
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7005698
RI
Enumeration date
04/18/2006
Last updated
10/29/2025
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