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General NPI Number Information
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NPI Number | 1780871624
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Entity Type | Individual
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Provider Name | MADHU BORRA MD
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Gender | Male
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 100 HOSPITAL RD
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4017
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Country | US
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Telephone | 410-535-4000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 191 PROVIDER ENROLLMENT
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City | ROCKLAND
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State | DE
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Zip | 19732-0191
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Country | US
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Telephone |
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Fax | 302-651-4945
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | C1-0011880
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License Number State | DE
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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 | D66650
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | C1-0011880
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | D66650
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License Number State | MD
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