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NPI 1699987388

NPI 1699987388 : TIMEA BOR MD : PAPILLION, NE

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General NPI Number Information
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    NPI Number           |    1699987388
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    Entity Type          |    Individual 
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    Provider Name        |    TIMEA BOR MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/04/2007
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    Last Update Date     |    12/11/2017
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Provider Practice Location Address
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    Address Line         |    11111 S 84TH ST 
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    City                 |    PAPILLION
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    State                |    NE
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    Zip                  |    68046-4122
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    Country              |    US
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    Telephone            |    402-593-3131
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7500 MERCY RD 
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    City                 |    OMAHA
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    State                |    NE
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    Zip                  |    68124-2319
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    Country              |    US
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    Telephone            |    855-524-4001
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    Fax                  |    402-398-5589
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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        |    208M00000X
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    Taxonomy Name        |    Hospitalist Physician
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    License Number       |    MD-35923
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    License Number State |    IA
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Taxonomy #2
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    Taxonomy Code        |    208M00000X
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    Taxonomy Name        |    Hospitalist Physician
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    License Number       |    21255
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    License Number State |    NE
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