Provider Demographics
NPI:1457093924
Name:BOROWICZ VASCULAR PC
Entity Type:Organization
Organization Name:BOROWICZ VASCULAR PC
Other - Org Name:SURGICAL ASSOCIATES OF MYRTLE BEACH VASCULAR LAB AND IMAGING
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO/VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOROWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-449-3333
Mailing Address - Street 1:4036 RIVER OAKS DR STE 2
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-6695
Mailing Address - Country:US
Mailing Address - Phone:843-449-3333
Mailing Address - Fax:843-796-2376
Practice Address - Street 1:845 82ND PKWY
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4614
Practice Address - Country:US
Practice Address - Phone:843-449-9621
Practice Address - Fax:843-449-4921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty