Active NPIIndividual provider

David B Bouslough, MD

Emergency Medicine in New London, Connecticut

NPI Number1407870330
Practice location
365 Montauk Ave, New London, CT 06320
Fax
203-688-9638
Last updated
July 28, 2020

David Bruce Bouslough is an Emergency Medicine based in New London, CT. David Bruce Bouslough practices in New London, CT and has the professional credentials of MD. The NPI Number for David Bruce Bouslough is 1407870330 and holds a License No. A96799 (AS). The current practice location address for David Bruce Bouslough is 365 Montauk Ave, New London, CT 06320 and can be reached out via phone at 860-442-0711 and via fax at 203-688-9638.

Provider Profile Details

NPI Number
1407870330
Provider Name
David Bruce Bouslough
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
365 Montauk Ave, New London, CT 06320
Phone Number
860-442-0711
Fax Number
203-688-9638
Primary Taxonomy
Emergency Medicine · 207P00000X
Sole Proprietor
No
Provider Enumeration Date
July 26, 2006
Last Update Date
July 28, 2020
Certification Date
July 28, 2020
NPI Status
Active

Provider Business Practice Location Address Details

Address
365 Montauk Ave
New London, CT 06320
Zip
06320
Phone Number
860-442-0711
Fax Number
203-688-9638
New London, CT 06320Get directions →

Provider Business Mailing Address Details

Address
20 York Street, Cb-2041
New Haven, CT 06510-3220
City
New Haven
State
CT
Zip
06510-3220
Phone Number
203-688-1734
Fax Number
203-688-9638

License Information

License Number (1)
A96799
License State (1)
AS
Taxonomy (1)
Emergency Medicine · 207P00000X
License Number (2)
MD11583
License State (2)
RI
Taxonomy (2)
Emergency Medicine · 207P00000X
License Number (3)
62616
License State (3)
CT
Taxonomy (3)
Emergency Medicine · 207P00000X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of David B Bouslough, MD?

The NPI number of David B Bouslough, MD is 1407870330. It was assigned on July 26, 2006 and is currently active in the NPPES registry.

What is the specialty of David B Bouslough, MD?

David B Bouslough, MD is registered under the primary taxonomy Emergency Medicine (code 207P00000X), licensed in AS under license number A96799.

Where does David B Bouslough, MD practice?

The practice location is 365 Montauk Ave, New London, CT 06320. The office can be reached at 860-442-0711 (phone) or 203-688-9638 (fax).

What is an NPI number?

A National Provider Identifier (NPI) 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). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1407870330 directly on the NPPES registry website.

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