Provider Demographics
NPI:1790974434
Name:DAVID J BORCHERS MD PC
Entity Type:Organization
Organization Name:DAVID J BORCHERS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:BORCHERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-927-8181
Mailing Address - Street 1:100 ELK RUN DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BASALT
Mailing Address - State:CO
Mailing Address - Zip Code:81621-9205
Mailing Address - Country:US
Mailing Address - Phone:970-927-8181
Mailing Address - Fax:970-927-8182
Practice Address - Street 1:100 ELK RUN DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621-9205
Practice Address - Country:US
Practice Address - Phone:970-927-8181
Practice Address - Fax:970-927-8182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36940174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COG68390Medicare UPIN
COC537548Medicare PIN