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Dr. Michael Ray Bourne, MD
Podiatrist in Stillwater, Minnesota
NPI 1164412649

Michael Ray Bourne is a Podiatrist based in Minneapolis, MN. Michael Ray Bourne practices in Stillwater, MN and has the professional credentials of MD. The NPI Number for Michael Ray Bourne is 1164412649 and holds a License No. 746 (Minnesota).

The current practice location address for Michael Ray Bourne is 1500 Curve Crest Blvd W, Stillwater, MN and can be reached out via phone at 651-439-1234 and via fax at 651-275-3325.

Location: 1500 Curve Crest Blvd W, Stillwater, MN, 55425-4516
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164412649
Provider Name
Michael Ray Bourne
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1500 Curve Crest Blvd W, Stillwater, MN, 55425-4516
Phone Number
651-439-1234
Fax Number
651-275-3325
Provider Enumeration Date
10/25/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
164225100 05 MN
43222300 05 WI
institution
Provider Business Practice Location Address Details
Address
1500 Curve Crest Blvd W
City
Stillwater
State
Minnesota
Zip
55082-6040
Phone Number
651-439-1234
Fax Number
651-275-3325
person
Provider Business Mailing Address Details
Address
1500 Curve Crest Blvd W
City
Stillwater
State
Minnesota
Zip
55082-6040
Phone Number
651-439-1234
Fax Number
651-275-3325
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
213E00000X
License No.
746 (Wisconsin)
Definition
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.
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
213ES0103X
License No.
746 (Wisconsin)
Definition
Definition to come...
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