MEDICARE: MRS. DARIAN BORCHERS PAC

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
1	363A00000X	Physician Assistant	50.006867RX	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316524788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DARIAN BORCHERS PAC

Provider Business Mailing Address
First Line	:	3170 KETTERING BLVD
Second Line	:
City	:	MORAINE
State	:	OH
Zip	:	45439-1924
Country	:	US
Telephone Number	:	937-991-3188
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 AVIATOR CT STE 250
Second Line	:
City	:	VANDALIA
State	:	OH
Zip	:	45377-9476
Country	:	US
Telephone Number	:	937-223-4900
Fax Number	:	937-223-4420

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2021
Last Update Date	:	03/02/2022

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Directions to “ MRS. DARIAN BORCHERS PAC” Practice Location

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