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NPI Code Detail

MEDICARE: MAUREEN BORREGO PA

MEDICARE: MAUREEN BORREGO PA
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
1363A00000XPhysician Assistant2000145765MO

General Provider Information

NPI Number : 1326142050
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAUREEN BORREGO PA
Provider Business Mailing Address
First Line : PO BOX 957683
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63195-1921
Country : US
Telephone Number : 573-756-6751
Fax Number : 573-756-6807
Provider Business Practice Location Address
First Line : 1106 HAZEL LN
Second Line :
City : FARMINGTON
State : MO
Zip : 63640-1999
Country : US
Telephone Number : 573-756-6751
Fax Number : 573-760-8044
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2006
Last Update Date : 09/26/2025

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Directions to “ MAUREEN BORREGO PA” Practice Location

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