MEDICARE: DR. MICHAEL E BOREN 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	207R00000X	Internal Medicine Physician	23498	AZ

General Provider Information

NPI Number	:	1962473041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL E BOREN MD

Provider Business Mailing Address
First Line	:	2001 W ORANGE GROVE RD
Second Line	:	STE. 604
City	:	TUCSON
State	:	AZ
Zip	:	85704-1139
Country	:	US
Telephone Number	:	520-219-6100
Fax Number	:	520-219-6119

Provider Business Practice Location Address
First Line	:	2001 W ORANGE GROVE RD
Second Line	:	STE. 604
City	:	TUCSON
State	:	AZ
Zip	:	85704-1139
Country	:	US
Telephone Number	:	520-219-6100
Fax Number	:	520-219-6119

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	11/15/2024

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