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1437194057

NPI Code Detail

MEDICARE: MICHAEL D BORDNER MD

MEDICARE: MICHAEL D BORDNER 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	207Q00000X	Family Medicine Physician	MD00024881	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01287747	OTHER	WA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	74319	OTHER	WA	L&I
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	314740	OTHER	WA	L&I POST 7/21/13

General Provider Information

NPI Number	:	1437194057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL D BORDNER MD

Provider Business Mailing Address
First Line	:	820 N CHELAN AVE
Second Line	:
City	:	WENATCHEE
State	:	WA
Zip	:	98801-2028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	916 KOALA AVE
Second Line	:
City	:	OMAK
State	:	WA
Zip	:	98841-9576
Country	:	US
Telephone Number	:	509-826-1800
Fax Number	:

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

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	05/07/2014

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Directions to “ MICHAEL D BORDNER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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