Individual
DR. SUZANNE BOURQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., B. SC
Contact information
Practice address
498 ESSEX ST, SUITE 105, BANGOR, ME 04401-3990
(207) 947-0558
Mailing address
498 ESSEX ST, SUITE 105, BANGOR, ME 04401-3990
(207) 947-0558
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD19400
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316225923
—
ME
Enumeration date
07/31/2011
Last updated
01/10/2022
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