Provider Demographics
NPI:1013963768
Name:BORDERS-ROBINSON, ANGALA B (DO)
Entity Type:Individual
Prefix:DR
First Name:ANGALA
Middle Name:B
Last Name:BORDERS-ROBINSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 CHICAGO AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1544
Mailing Address - Country:US
Mailing Address - Phone:612-879-1000
Mailing Address - Fax:612-879-9116
Practice Address - Street 1:2828 CHICAGO AVE STE 200
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1544
Practice Address - Country:US
Practice Address - Phone:612-879-1000
Practice Address - Fax:612-879-9116
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN535412084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0570033OtherPHP MCA
MI383553974OtherCOMMERCIAL INSURANCE
MI135780023OtherBCBS PROVIDER NUMBER
MI130023121OtherRAILROAD MEDICARE
MI4B84119OtherHPM
MI424892511Medicaid
MI1357800235OtherBLUE CARE NETWORK
MI561246OtherSELECT CARE
MIC5483OtherMCARE
MI0500011OtherPHYSICIANS HEALTH PLAN
MI38262737007OtherCHAMPUS
MI0500011OtherPHYSICIANS HEALTH PLAN
MI135780023OtherBCBS PROVIDER NUMBER