Provider Demographics
NPI:1740245927
Name:BORAK, HUGH M (MD)
Entity type:Individual
Prefix:
First Name:HUGH
Middle Name:M
Last Name:BORAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 MCFARLAND CIR N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-1800
Mailing Address - Country:US
Mailing Address - Phone:205-345-7000
Mailing Address - Fax:205-343-0910
Practice Address - Street 1:208 MCFARLAND CIR N
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-1800
Practice Address - Country:US
Practice Address - Phone:205-345-7000
Practice Address - Fax:205-343-0910
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL233112085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009989850Medicaid
AL009989760Medicaid
AL009989810Medicaid
AL009989860Medicaid
AL009989820Medicaid
AL051501956Medicaid
AL009989750Medicaid
AL009989780Medicaid
AL009989870Medicaid
AL009989770Medicaid
AL009989740Medicaid
AL009989830Medicaid
AL009989840Medicaid
AL300117979Medicare PIN
AL009989780Medicaid
AL009989870Medicaid