Individual
SEAN DAVID BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7190 CRESTWOOD BLVD, FREDERICK, MD 21703-7314
(240) 529-1700
Mailing address
2101 E JEFFERSON ST, ROCKVILLE, MD 20852-4908
(800) 777-7904
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101263331
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116029690
VA
Other
Enumeration date
06/22/2016
Last updated
07/26/2021
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