Charles L Boursier, MD | |
2817 New Pinery Rd., Divine Savior Healthcare Inc, Portage, WI 53901-0387 | |
(608) 742-4131 | |
(608) 745-5173 |
Full Name | Charles L Boursier |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 2817 New Pinery Rd., Portage, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619950888 | NPI | - | NPPES |
34133600 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 43764020 (Wisconsin) | Primary |
Entity Name | Epss Peoria Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831421056 PECOS PAC ID: 1850587007 Enrollment ID: O20101130000569 |
Mailing Address | Practice Location Address |
---|---|
Charles L Boursier, MD 2817 New Pinery Rd., Divine Savior Healthcare Inc, Portage, WI 53901-0387 Ph: (608) 742-4131 | Charles L Boursier, MD 2817 New Pinery Rd., Divine Savior Healthcare Inc, Portage, WI 53901-0387 Ph: (608) 742-4131 |
Terra Thimm, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2817 New Pinery Rd, Portage, WI 53901 Phone: 608-742-4131 | |
Michael C Walters, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2817 New Pinery Rd, Portage, WI 53901 Phone: 608-745-5689 Fax: 608-742-6098 | |
James T Gariti Sr., MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, WI 53901 Phone: 608-742-4131 Fax: 608-742-6098 | |
Gregory S Keeling, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, WI 53901 Phone: 608-742-4131 Fax: 608-745-5173 | |
Jennifer Marie Bahr, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2817 New Pinery Rd, Divine Savior Healthcare, Inc., Portage, WI 53901 Phone: 608-742-4131 Fax: 608-745-5173 | |
Mr. Brian T. Stubitsch, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, WI 53901 Phone: 608-742-4131 Fax: 608-742-6098 | |
Hythem Abad, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2817 New Pinery Rd, Portage, WI 53901 Phone: 608-742-4131 |