Individual
BRANDON ELLIOTT BOURGEOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
788 8TH AVE SE, SUITE 100, CEDAR RAPIDS, IA 52401-2107
(319) 363-2682
(319) 363-1473
Mailing address
788 8TH AVE SE, SUITE 100, CEDAR RAPIDS, IA 52401-2107
(319) 363-2682
(319) 363-1473
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
34399
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0254680
—
IA
Enumeration date
06/08/2005
Last updated
12/27/2011
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