Provider Demographics
NPI:1861448086
Name:BORST, CHRISTOPHER ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ANDREW
Last Name:BORST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:A
Other - Last Name:BORST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1818 HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2619
Mailing Address - Country:US
Mailing Address - Phone:803-758-2602
Mailing Address - Fax:803-253-8896
Practice Address - Street 1:1220 21ST AVE N
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-7401
Practice Address - Country:US
Practice Address - Phone:843-626-9379
Practice Address - Fax:843-448-0707
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9560207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC095603Medicaid
D90780Medicare UPIN