Healthcare Provider Details

I. General information

NPI: 1184823288
Provider Name (Legal Business Name): JAMIL FOUAD BORGI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4228 HOUMA BLVD STE 510
METAIRIE LA
70006-3015
US

IV. Provider business mailing address

1350 W BETHUNE ST APT 907
DETROIT MI
48202-2600
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-6113
  • Fax:
Mailing address:
  • Phone: 313-409-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301089779
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number4301089779
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number340138
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: