Provider Demographics
NPI:1629078027
Name:BORGER, ANNETTE (MD)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:BORGER
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 1:1605 N CEDAR CREST BLVD STE 110B
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1449
Practice Address - Street 1:1310 ROUTE 209 STE 103
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:PA
Practice Address - Zip Code:18331-7751
Practice Address - Country:US
Practice Address - Phone:610-951-4500
Practice Address - Fax:610-951-4600
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD068283L207Q00000X, 208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA002810OtherFIRST PRIORITY HEALTH
202991704OtherHEALTH AMERICA
614574OtherHIGHMARK
5092509OtherAETNA
52157OtherGEISINGER
PA20057837OtherAMERIHEALTH MERCY
PA0017584980003Medicaid
50059317OtherKEYSTONE CAPTIAL BC
PA029290URGMedicare PIN
50059317OtherKEYSTONE CAPTIAL BC
PA029290WDBMedicare PIN