MEDICARE: ABBIE BOREM

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	133V00000X	Registered Dietitian	2762	SC

General Provider Information

NPI Number	:	1710833041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBIE BOREM

Provider Business Mailing Address
First Line	:	103 CANNON LN
Second Line	:
City	:	TAYLORS
State	:	SC
Zip	:	29687-4825
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 VERDAE BLVD STE 202
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-4098
Country	:	US
Telephone Number	:	865-522-2100
Fax Number	:

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

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “ ABBIE BOREM ” Practice Location

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