Healthcare Provider Details

I. General information

NPI: 1689705535
Provider Name (Legal Business Name): ARMAN BORHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 03/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3212 HICKORY RD SUITE B
MISHAWAKA IN
46545-8862
US

IV. Provider business mailing address

PO BOX 126
GRANGER IN
46530-0126
US

V. Phone/Fax

Practice location:
  • Phone: 574-251-0498
  • Fax: 574-251-0068
Mailing address:
  • Phone: 574-251-0498
  • Fax: 574-251-0068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number01065644A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number059901
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number01065644A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number059901
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: