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General NPI Number Information
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NPI Number | 1518059997
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Entity Type | Individual
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Provider Name | ROBERT I BOORSTEIN DO
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Gender | Male
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 04/15/2016
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Provider Practice Location Address
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Address Line | 28237 ORCHARD LAKE RD STE 103
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3740
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Country | US
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Telephone | 248-752-0230
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Fax | 248-855-1700
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Provider Business Mailing Address
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Address Line | 7082 HAWK WOODS DR
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-4581
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Country | US
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Telephone | 248-752-0230
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Fax | 248-855-1701
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | RB007073
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License Number State | MI
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