Individual
ROBERT C BOURGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 6TH AVE S, BIRMINGHAM, AL 35233-2110
(205) 801-8000
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
9304
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010716
BLUE CROSS
AL
05
—
000010716
—
AL
01
—
00126738
MISSISSIPPI MEDICAID
MS
01
—
051512036
BLUE CROSS
AL
01
—
051512050
BLUE CROSS
AL
01
—
060002735
RAILROAD MEDICARE
AL
05
—
263918527A
—
GA
01
—
C71642
VIVA
AL
Enumeration date
05/27/2006
Last updated
06/29/2023
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