WALLACE BOURGEOIS (NPI# 1811317209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811317209 |
| Entity Type | Individual |
| Full Name | WALLACE BOURGEOIS |
| Credential | M.D. |
| Practice Address |
44 Binney St # D-3119 Boston MA 02115 |
| Mailing Address |
44 Binney St # D-3119 Boston MA 02115-6013 |
| Practice Telephone | 6176325345 |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2018-07-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 274015 | MA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
44 BINNEY ST # D-3119 |
| City | BOSTON |
| State | MA |
| Zip Code | 02115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1679189112 | Tara Baxter | Orthopaedic Surgery | Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 | 2020-09-21 |
| 1053923110 | Wendy Tu | Student in an Organized Health Care Education/Training Program | 75 Francis Street Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115 | 2020-08-20 |
| 1477177335 | Nicolas Wyvekens | Student in an Organized Health Care Education/Training Program | 75 Francis Street Department of Pathology, Brigham And, Boston, MA 02115 | 2020-06-05 |
| 1669095923 | Erin Crocker | Student in an Organized Health Care Education/Training Program | Northeastern University Physician Assistant Program, 360 Huntington Avenue, Boston, MA 02115 | 2020-05-21 |
| 1033732417 | Tyler Francis Hayes | Student in an Organized Health Care Education/Training Program | Gordon Hall, Suite 213, 25 Shattuck Street, Boston, MA 02115 | 2020-05-20 |
| 1982225090 | Emily Blake | Student in an Organized Health Care Education/Training Program | 202 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 | 2020-04-29 |
| 1891315495 | Stephanie Schoch | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave., 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| 1427678093 | Meghan Miles | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| Find all providers in zip 02115 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639790280 | Allison Seats | Pediatrics | 265 Hyde Park Ave Apt 1rf, Boston, MA 02130-4222 | 2020-05-05 |
| 1154957132 | Katherine Erin Douglas | Pediatrics | 801 Albany Street, 3rd Floor, Department of Pediatrics, Boston, MA 02119 | 2020-03-21 |
| 1346871381 | Heather Mccaslin Kempczinski | Pediatrics | 360 Beacon St Apt 1, Boston, MA 02116-1063 | 2020-01-29 |
| 1083148167 | Daniel Digiacomo | Pediatrics | 55 Fruit St # 165, Boston, MA 02114-2621 | 2017-04-17 |
| 1568814283 | Jessica Leigh Dicarlo | Pediatrics | 800 Tufts Medical Center, Box 286, Department of Pediatrics, Boston, MA 02111-1651 | 2016-07-06 |
| 1336598598 | Nicole Savina Rittershaus | Pediatrics | 354 Tremont Street, Boston, MA 02116 | 2016-06-08 |
| 1255793493 | Kelsey A. Egan | Pediatrics | 840 Harrison Ave # Menino4, Boston, MA 02118-2905 | 2016-03-27 |
| 1851787626 | Tierney Mancuso Morrison | Pediatrics | 300 Longwood Ave # 961, Boston, MA 02115-5724 | 2015-04-08 |
| 1710379797 | Marleny Yordania Aquino Cabrera | Pediatrics | 725 Albany St Ste 8c, Boston, MA 02118-2526 | 2015-02-27 |
| 1558762203 | Desiree Sierra Velez | Pediatrics | 32 Fruit St Fl 6, Boston, MA 02114-2620 | 2014-09-12 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.