=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649233537
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT ELLIOTT BORSON DPM
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2006
-----------------------------------------------------
Last Update Date | 02/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2349 COOLIDGE HWY
-----------------------------------------------------
City | BERKLEY
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48072-1550
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-399-1936
-----------------------------------------------------
Fax | 248-399-9286
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4536 STONEVIEW
-----------------------------------------------------
City | WEST BLOOMFIELD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48322-3498
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-399-1936
-----------------------------------------------------
Fax | 248-399-9286
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | 5901000957
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------