Individual
ANDRE BOURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
625 19TH STREET SOUTH, BIRMINGHAM, AL 35249-1900
(205) 934-4696
Mailing address
625 19TH STREET SOUTH, BIRMINGHAM, AL 35249-1900
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
94155
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
941556
—
SC
Enumeration date
04/15/2021
Last updated
06/13/2025
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