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NPI Code Detail

MEDICARE: DR. MICHAEL ANTHONY BORSUK DO

MEDICARE: DR. MICHAEL ANTHONY BORSUK DO
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
1207P00000XEmergency Medicine Physician81259-21WI
2207P00000XEmergency Medicine Physician109727GA

General Provider Information

NPI Number : 1407449432
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL ANTHONY BORSUK DO
Provider Business Mailing Address
First Line : 36065 SANTA FE AVE
Second Line :
City : FORT CAVAZOS
State : TX
Zip : 76544-5060
Country : US
Telephone Number : 254-288-8000
Fax Number :
Provider Business Practice Location Address
First Line : 6600 VAN AALST BLVD
Second Line :
City : FORT BENNING
State : GA
Zip : 31905-2102
Country : US
Telephone Number : 762-408-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2021
Last Update Date : 12/11/2025

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