Individual
DR. JOHN ELLIOT BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
(704) 295-3121
Mailing address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
(704) 295-3121
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25883
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000282479
UNISON HEALTH PLAN OF SC
SC
01
—
0841480
UNITED HEALTHCARE
NC
01
—
100706
WELLNESS
NC
01
—
10482
KANAWHA
NC
01
—
10610
BCBS MEDPOINT
NC
01
—
11125
WELLPATH
NC
01
—
141004
COVENTRY
NC
01
—
1533931002
CIGNA
NC
01
—
17059
BCBS
NC
01
—
180019848
RAILROAD MEDICARE
—
01
—
1963
DOCTORS HEALTH PLAN
NC
01
—
20094032
SELECT HEALTH OF SC/FIRST CHOICE
SC
01
—
21170
MEDCOST
NC
01
—
376565
MAMSI
NC
01
—
4068491
AETNA
NC
01
—
6872
PARTNERS
NC
01
—
777013
WELLCARE
SC
01
—
80783
CHCCARES OF SC
SC
05
—
8917059
—
NC
05
—
N25883
—
SC
Enumeration date
05/04/2006
Last updated
10/16/2015
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