Provider Demographics
NPI:1437157807
Name:BORNT, MARSHA D (MD)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:D
Last Name:BORNT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MONUMENT RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5048
Mailing Address - Country:US
Mailing Address - Phone:717-741-0857
Mailing Address - Fax:717-741-3630
Practice Address - Street 1:23 MONUMENT RD
Practice Address - Street 2:SUITE 230
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5048
Practice Address - Country:US
Practice Address - Phone:717-741-0857
Practice Address - Fax:717-741-3630
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-11
Last Update Date:2007-07-08
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-30
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB40270Medicare UPIN