Wallace Bourgeois
M.D. | Pediatric Hematology-Oncology | Male
Wallace Bourgeois, M.D. is a Boston, Massachusetts based Pediatric doctor with medical specialization in
Pediatric Hematology-Oncology.
Current practice location of Wallace Bourgeois is
450 Brookline Ave, Boston, Massachusetts - 02215-5418. He can be contacted on phone at
617-632-2423.
Wallace Bourgeois is a sole proprietor of his business.
NPI number (Unique professional ID) for Wallace Bourgeois is
1811317209 which was assigned by NPPES on 24 Apr, 2014 and it was last updated on 22 Feb, 2021.
Wallace Bourgeois license number is
274015 for Pediatrics Pediatric Hematology-Oncology (2080P0207X) in Massachusetts.
Wallace Bourgeois is trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.
Complete Profile:
Wallace Bourgeois basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Pediatric Hematology-Oncology |
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| Provider Name : | Wallace Bourgeois |
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| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Wallace Bourgeois address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 450 Brookline Ave
Boston, MA, 02215-5418
United States |
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| Phone Number : | 617-632-2423 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1811317209 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 24 Apr, 2014 |
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| Last Updated On : | 22 Feb, 2021 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Wallace Bourgeois are as mentioned. Primary taxonomy code for Wallace Bourgeois, M.D. is
2080P0207X (Pediatrics Pediatric Hematology-Oncology).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | No | 274015 | MA |
| 2080P0207X | Pediatrics Pediatric Hematology-Oncology | Yes | 274015 | MA |
| 390200000X | Student in an Organized Health Care Education/Training Program | No | | |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
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300 LONGWOOD AVE,
BOSTON, MA, 02115-5724
United States | BOSTON, MA | 617-355-6000 |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 44 Binney St # D-3119
Boston, MA, 02115-6013
United States |
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Business Location:
Patients can refer following map for directions to
Wallace Bourgeois practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.