Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | 2012-01790 | NC |
N | 2086S0127X | Trauma Surgeon | 35-052836 | OH |
NPI | 1174519888 |
---|---|
Provider Name | Mr. Anthony P Borzotta |
First Address | Gastonia, NC 28054-2134 |
Second Address | Gastonia, NC 28054-2134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 04/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2258113 | (05) | OH |
5921841 | (05) | NC |
A08117 | (02) | OH |