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General NPI Number Information
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NPI Number | 1508829615
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Entity Type | Organization
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Legal Business Name | MATTHEW P. BORST, M.D. P.C.
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 04/03/2008
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Provider Practice Location Address
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Address Line | 1300 N 12TH ST STE 614
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City | PHOENIX
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State | AZ
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Zip | 85006-2848
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Country | US
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Telephone | 602-253-5300
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Fax | 602-253-4400
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Provider Business Mailing Address
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Address Line | 1300 N 12TH ST STE 614
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City | PHOENIX
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State | AZ
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Zip | 85006-2848
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Country | US
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Telephone | 602-253-5300
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Fax | 602-253-4400
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MATTHEW P BORST
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Credential | M.D.
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Telephone | 602-253-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 20785
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License Number State | AZ
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