Provider Demographics
NPI:1528210119
Name:BORER, STEVEN MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:BORER
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 1:100 RETREAT AVE
Mailing Address - Street 2:811
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-2563
Mailing Address - Country:US
Mailing Address - Phone:860-522-5712
Mailing Address - Fax:860-520-4270
Practice Address - Street 1:100 RETREAT AVE
Practice Address - Street 2:811
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-2563
Practice Address - Country:US
Practice Address - Phone:860-522-5712
Practice Address - Fax:860-520-4270
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT046995207R00000X
CT46995207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008017053Medicaid
CT008017053Medicaid