Individual
THERESA ELAINE BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8821 COLUMBIA 100 PKWY, COLUMBIA, MD 21045-2274
(410) 997-1700
(410) 740-8315
Mailing address
8821 COLUMBIA 100 PKWY, COLUMBIA, MD 21045-2274
(410) 997-1700
(410) 740-8315
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D86548
MD
Other
Enumeration date
04/20/2016
Last updated
06/30/2019
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