Provider Demographics
NPI:1528020716
Name:BORGER, MICHAEL H (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:BORGER
Suffix:
Gender:M
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:PO BOX 996
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46581-0996
Mailing Address - Country:US
Mailing Address - Phone:574-372-7617
Mailing Address - Fax:574-372-7649
Practice Address - Street 1:1001 N MAIN ST
Practice Address - Street 2:SUITE ONE
Practice Address - City:NAPPANEE
Practice Address - State:IN
Practice Address - Zip Code:46550-1038
Practice Address - Country:US
Practice Address - Phone:574-773-4141
Practice Address - Fax:574-773-4898
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02000607207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100367590Medicaid
IN224480Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
INE33228Medicare UPIN
IN100367590Medicaid