Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD033339E | PA |
Y | 208600000X | Surgeon | MD033339E | PA |
N | 2082S0105X | Plastic Hand Surgeon | MD033339E | PA |
NPI | 1275505141 |
---|---|
Provider Name | Michael William Born |
First Address | York, PA 17403 |
Second Address | York, PA 17403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 22/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001164812004 | (05) | PA |
01873201 | CAPITOL BLUE CROSS (01) | |
1523691 | GATEWAY (01) | PA |
20009842 | AMERIHEALTH MERCY (01) | PA |
240006830 | RAILROAD MEDICARE (01) | PA |
742753 | BLUE SHIELD (01) | PA |
742753 | KEYSTONE (01) | PA |
C34693 | (02) | |
P018712A002 | CHAMPUS (01) |