Individual
RENEE A. BOURQUARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 WARM SPRINGS AVE, STE B, BOISE, ID 83712-6243
(208) 381-6930
(208) 381-6931
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M5303
ID
Other
Enumeration date
05/17/2006
Last updated
07/24/2013
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