Provider Demographics
NPI:1093026007
Name:BORGER, JUDITH HAUG (DO)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:HAUG
Last Name:BORGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:HAUG
Other - Last Name:VIOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1916 CAVINESS ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-8485
Mailing Address - Country:US
Mailing Address - Phone:919-684-6724
Mailing Address - Fax:
Practice Address - Street 1:1638 OWEN DR
Practice Address - Street 2:CAPE FEAR VALLEY MEDICAL CENTER
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3424
Practice Address - Country:US
Practice Address - Phone:919-684-6724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101018926207P00000X
NC2013-00950207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCD595Medicare PIN