Provider Demographics
NPI:1023000486
Name:BORIK, ANNE (DO)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:
Last Name:BORIK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 W. CARLA VISTA DR. #7150
Mailing Address - Street 2:PO BOX 7150
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246
Mailing Address - Country:US
Mailing Address - Phone:602-427-7967
Mailing Address - Fax:602-331-5429
Practice Address - Street 1:161 W RODEO RD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-6201
Practice Address - Country:US
Practice Address - Phone:520-836-1772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-21
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2962207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ311100Medicaid
AZ311100Medicaid
AZF87583Medicare UPIN
AZ311100Medicaid