Provider Demographics
NPI:1366678344
Name:BORTE, BERNADETTE (MD)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:BORTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-6585
Mailing Address - Fax:
Practice Address - Street 1:1210 W 18TH ST
Practice Address - Street 2:STE 100
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-9890
Practice Address - Country:US
Practice Address - Phone:605-312-8500
Practice Address - Fax:605-312-8501
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2994212084N0400X
MTMED-PHYS-LIC-742332084N0400X
TN595192084N0400X
MS264252084N0400X
NH194282084N0400X
ND156902084N0400X
SD91212084N0400X
FLME1394062084N0400X
GA836452084N0400X
IAMD-420672084N0400X
PAMD4757202084N0400X
OH35.1298232084N0400X
MI43011192872084N0400X
ORMD2010002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology