Individual
MICHAEL HAL BOURNE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1160 E 3900 S STE 4050, SALT LAKE CITY, UT 84124-1264
(801) 266-3418
Mailing address
PO BOX 741729, ATLANTA, GA 30374-1729
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
12857513-1205
UT
207RP1001X
Pulmonary Disease Physician
Primary
12857513-1205
UT
Other
Enumeration date
05/22/2013
Last updated
06/11/2024
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