National Provider Identifier Database

MICHAEL R BOURNE, MD – NPI #1164412649
Podiatrist

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.


Contact Information

MICHAEL R BOURNE, MD
1500 CURVE CREST BLVD W
STILLWATER, MN55082-6040
Phone: 651-439-1234
Fax: 651-275-3325
Website:
Specialty Taxonomy Code
* Podiatrist 213E00000X
Surgery, Foot & Ankle 213ES0103X

* Indicates primary specialty

NPI Profile & details for MICHAEL R BOURNE

NPI Number 1164412649
Credentials MD
Entity Individual
Enumeration date 10/25/2005
Last updated 04/23/2026 - About 1 months ago
Sole proprietor1 No
Identifiers
  • MN License #: 445
  • WI License #: 746
  • MN Medicaid: 164225100
  • WI Medicaid: 43222300
Hospital affiliation n/a

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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