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General NPI Number Information
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NPI Number | 1831363886
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Entity Type | Organization
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Legal Business Name | BORKOWF AND BORKOVEC MD SC
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Dates
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Enumeration Date | 04/21/2008
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Last Update Date | 01/28/2009
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Provider Practice Location Address
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Address Line | 2350 NORTH LAKE DRIVE SUITE 500
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City | MILWAUKEE
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State | WI
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Zip | 53211-4507
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Country | US
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Telephone | 414-289-9669
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Fax | 414-289-9693
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Provider Business Mailing Address
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Address Line | 2350 NORTH LAKE DRIVE SUITE 500
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City | MILWAUKEE
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State | WI
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Zip | 53211-4507
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Country | US
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Telephone | 414-289-9669
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Fax | 414-289-9693
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Authorized Official
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Title or Position | OWNER
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Name | TERRE M BORKOVEC
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Credential | MD
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Telephone | 414-289-9668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 27123
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License Number State | WI
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