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Contact Information

JASON BOURQUE, MD
358 BROADWAY
SUITE 202
BANGOR, ME04401-3985
 Phone: 207-907-3690
 Fax: 207-907-3691
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adult Reconstructive Orthopaedic Surgery

207XS0114X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for JASON BOURQUE · (Male)

NPI # 1659651214
Status Active
Credentials MD
Entity Individual
Enumeration date 08/26/2011
Last updated 12/15/2021 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • CA License # A117876
  • ME License # MD19268
Hospital affiliation(s)
  • KAISER FOUNDATION HOSPITAL - (Acute Care)
    99 MONTECILLO RD
    SAN RAFAEL, CA 94903
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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