MEDICARE: DR. CHRISTOPHER ANDREW BORST 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	9560	SC

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

General Provider Information

NPI Number	:	1861448086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER ANDREW BORST MD

Provider Business Mailing Address
First Line	:	1818 HENDERSON ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-2619
Country	:	US
Telephone Number	:	803-758-2602
Fax Number	:	803-253-8896

Provider Business Practice Location Address
First Line	:	1220 21ST AVE N
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-7401
Country	:	US
Telephone Number	:	843-626-9379
Fax Number	:	843-448-0707

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	06/17/2014

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