Individual
MR. AYINDE T BOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5383
Mailing address
PO BOX 3746, SOUTHFIELD, MI 48037-3746
(248) 948-7109
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101016738
MI
207R00000X
Internal Medicine Physician
OS 10715
FL
Other
Enumeration date
05/17/2007
Last updated
03/21/2010
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