Healthcare Provider Details

I. General information

NPI: 1689881898
Provider Name (Legal Business Name): LAMIA BORIC M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 W BELL RD BLDG A
GLENDALE AZ
85308-8529
US

IV. Provider business mailing address

PO BOX 910221
DALLAS TX
75391-0221
US

V. Phone/Fax

Practice location:
  • Phone: 623-487-4822
  • Fax: 602-230-9350
Mailing address:
  • Phone: 520-519-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number59285
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: