IndividualActive
Michael Bourne, MD
NPI 1073505582 · Adult Reconstructive Orthopaedic Surgery Physician · Salt Lake City, UT
Provider details
- NPI number
- 1073505582
- Entity type
- Individual
- Primary specialty
- Adult Reconstructive Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 1818921205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1160 E 3900 S Ste 5000
Salt Lake City, UT 84124-1275
Phone: (801) 261-7479
Fax: (801) 261-7429
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 100253
Atlanta, GA 30384-0253
Registry dates
- Enumerated
- 2005-08-19
- Last updated
- 2022-01-27
- Certified
- 2020-05-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.