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NPI Code Detail

MEDICARE: DR. IRIS WAGMAN BOROWSKY M.D., PHD

MEDICARE: DR. IRIS WAGMAN BOROWSKY M.D., PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician37597MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11007256OTHERMNPREFERRED ONE
212-00069OTHERMNMEDICA CHOICE
38T586BOOTHERMNBCBS
4768033OTHERMNARAZ
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8HP10158OTHERMNHEALTHPARTNERS
912-74806OTHERMNMEDICA PRIMARY
10108191OTHERMNUCARE

General Provider Information

NPI Number : 1174569396
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IRIS WAGMAN BOROWSKY M.D., PHD
Provider Business Mailing Address
First Line : UNIVERSITY OF MINNESOTA PHYSICIANS
Second Line : MCNAMARA ALUMNI CENTER, 200 OAK STREET SE, SUITE 260
City : MINNEAPOLIS
State : MN
Zip : 55455
Country : US
Telephone Number : 612-626-2820
Fax Number : 612-624-0997
Provider Business Practice Location Address
First Line : 2001 BLOOMINGTON AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-3074
Country : US
Telephone Number : 612-301-3433
Fax Number : 612-627-4205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 10/24/2014

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