Charles L Boursier, MD Valid NPI
Individual provider · Emergency Medicine Physician · Portage, WI
- NPI
- 1619950888
- Type
- Individual (Type 1)
- Primary specialty
- Emergency Medicine Physician (Emergency Medicine)
- Specialty group
- Allopathic & Osteopathic Physicians
- Taxonomy code
- 207P00000X
- License number
- 43764020 (WI)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2005-11-22
- Last updated
- 2012-01-30
Practice location
2817 New Pinery Rd., Divine Savior Healthcare Inc
Portage, WI 53901-0387
(608) 742-4131