Provider Demographics
NPI:1558329482
Name:BORER, MARY MARGARET (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY MARGARET
Middle Name:
Last Name:BORER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARY MARGARET
Other - Middle Name:
Other - Last Name:STOECKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9 BARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2801
Mailing Address - Country:US
Mailing Address - Phone:540-230-2300
Mailing Address - Fax:
Practice Address - Street 1:9 BARBOUR DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2801
Practice Address - Country:US
Practice Address - Phone:757-595-3016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227203208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics