IndividualActive
Brian Bourgeault, PA
NPI 1962651604 · Medical Physician Assistant · Springfield, MA
Provider details
- NPI number
- 1962651604
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- 2603 (MA)
Mailing address
280 Chestnut St
Springfield, MA 01199-1000
Registry dates
- Enumerated
- 2008-09-18
- Last updated
- 2011-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.