MEDICARE: A. MICHAEL BORKON MD

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	R5G80	MO
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	MD476209	PA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336190602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	A. MICHAEL BORKON MD

Provider Business Mailing Address
First Line	:	3421 CONCORD RD
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-9001
Country	:	US
Telephone Number	:	717-851-6454
Fax Number	:	717-851-1665

Provider Business Practice Location Address
First Line	:	30 MONUMENT RD STE 1100
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17403-5024
Country	:	US
Telephone Number	:	717-851-6454
Fax Number	:	717-851-1665

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	11/19/2021

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