Individual
DR. MICHAEL V BOURN
Active
Individual
DR. MICHAEL V BOURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
34-00-4435-B
OH
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
34.007735
OH
207RA0401X
Addiction Medicine (Internal Medicine) Physician
34.007735
OH
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
61-21847
OH
208VP0014X
Interventional Pain Medicine Physician
34.007735
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2320401
—
OH
Enumeration date
07/07/2006
Last updated
05/20/2022
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