Provider Demographics
NPI:1700095742
Name:BORIEUX, MARC-YRIANE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC-YRIANE
Middle Name:
Last Name:BORIEUX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1897 HIGHWAY 211 NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOSCHTON
Mailing Address - State:GA
Mailing Address - Zip Code:30548-3513
Mailing Address - Country:US
Mailing Address - Phone:678-820-7979
Mailing Address - Fax:678-820-7980
Practice Address - Street 1:1897 HIGHWAY 211 NW
Practice Address - Street 2:SUITE 100
Practice Address - City:HOSCHTON
Practice Address - State:GA
Practice Address - Zip Code:30548-3513
Practice Address - Country:US
Practice Address - Phone:678-820-7979
Practice Address - Fax:678-820-7980
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA059604208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA466268771BMedicaid