Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 29591 | GA |
NPI | 1003879925 |
---|---|
Provider Name | Howard E Borger |
First Address | Atlanta, GA 30339-6407 |
Second Address | Marietta, GA 30060-9408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2006 |
Last Update Date | 19/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000347597D | (05) | GA |
18BDFCH | MEDICARE ID (01) | GA |
D28979 | (02) | GA |