Healthcare Provider Details

I. General information

NPI: 1033228077
Provider Name (Legal Business Name): MARK S BORER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 WALKER RD STE. 32-2
DOVER DE
19904-2756
US

IV. Provider business mailing address

846 WALKER RD STE. 32-2
DOVER DE
19904-2756
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-2265
  • Fax: 302-674-3321
Mailing address:
  • Phone: 302-674-2265
  • Fax: 302-674-3321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0002941
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: