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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 Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for MICHAEL R BOURNE · (Male)

NPI Number 1164412649
Status Active
Credentials MD
Entity Individual
Enumeration date 10/25/2005
Last updated 04/23/2026 - About 1 months ago
Sole proprietor 1 No
Identifiers
  • MN License # 445
  • WI License # 746
  • MN Medicaid 164225100
  • WI Medicaid 43222300
Hospital affiliation(s)
  • LAKEVIEW MEMORIAL HOSPITAL - (Acute Care)
    927 WEST CHURCHILL STREET
    STILLWATER, MN 55082
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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