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Individual

DR. JASON BOURQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
358 BROADWAY, SUITE 202, BANGOR, ME 04401-3985
(207) 907-3690
(207) 907-3691
Mailing address
PO BOX 934, BANGOR, ME 04402-0934
(207) 907-3339
(207) 907-1214

Taxonomy

Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
A117876
CA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
MD19268
ME

Other

Enumeration date
08/26/2011
Last updated
12/15/2021
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