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Contact Information

DAVID B BOUSLOUGH, MD
365 MONTAUK AVE
NEW LONDON, CT06320
 Phone: 860-442-0711
 Fax: 203-688-9638
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for DAVID B BOUSLOUGH · (Male)

NPI # 1407870330
Status Active
Credentials MD
Entity Individual
Enumeration date 07/26/2006
Last updated 07/28/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • AS License # A96799
  • CT License # 62616
  • RI License # MD11583
  • RI Medicaid 7056948
  • MA Other 06222010 TUFTS HEALTH PLAN
  • RI Other 06292010 BCBSRI
  • RI Other 07082010 NHPRI
  • RI Other 1407870330 NPI
  • RI Other 939025129 RI MEDICARE GROUP NUMBER
  • RI Other 12142010 TRICARE
Hospital affiliation(s)
  • LAWRENCE & MEMORIAL HOSPITAL - (Acute Care)
    365 MONTAUK AVE
    NEW LONDON, CT 06320
  • MERCY HOSPITAL - CADILLAC - (Acute Care)
    400 HOBART ST
    CADILLAC, MI 49601
  • MERCY HOSPITAL - GRAYLING - (Acute Care)
    1100 E MICHIGAN AVE
    GRAYLING, MI 49738
  • WESTERLY HOSPITAL - (Acute Care)
    25 WELLS STREET
    WESTERLY, RI 02891
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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