Provider Demographics
NPI:1891046454
Name:BORNS, MATTHEW (DPM)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:BORNS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6831 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3386
Mailing Address - Country:US
Mailing Address - Phone:704-376-3947
Mailing Address - Fax:704-376-9487
Practice Address - Street 1:6831 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3386
Practice Address - Country:US
Practice Address - Phone:704-376-3947
Practice Address - Fax:704-376-9487
Is Sole Proprietor?:No
Enumeration Date:2012-09-23
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC626213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery