Individual provider · Type 1 NPI

Brian Bourgeault, PA

Medical Physician Assistant · Springfield, MA

NPI number 1962651604 Active

Practice location

11 Wilbraham Road, 2nd Floor
Springfield, MA 01109-3161

Call (413) 794-2511 Map

Fax (413) 794-8428

Mailing address

280 Chestnut St, 2nd Floor
Springfield, MA 01199-1000

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X2603 (MA)

Medical Physician Assistant: Definition to come...

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About NPI 1962651604

Brian Bourgeault, PA's National Provider Identifier is 1962651604, issued on Sep 18, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Springfield, MA. The record was last updated on Jun 18, 2026.