Healthcare Provider Details

I. General information

NPI: 1902890718
Provider Name (Legal Business Name): GAYLE J BORKOWSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 05/14/2021
Certification Date: 05/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S. MAIN STREET
MILFORD IN
46542
US

IV. Provider business mailing address

PO BOX 247
MILFORD IN
46542
US

V. Phone/Fax

Practice location:
  • Phone: 574-832-6246
  • Fax: 574-832-2001
Mailing address:
  • Phone: 574-832-6246
  • Fax: 574-832-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01042838
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: