Borman, Richard J
Borman, Richard J is an individual health care provider with primary practice located at 3601 30Th Ave Ste 205, Kenosha WI 53144. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Borman, Richard J can be contacted via phone (262) 652-7002.Contact Information
Primary practice address
3601 30Th Ave Ste 205
Kenosha WI 53144
Phone: (262) 652-7002
Fax: (262) 652-7242
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 27569 | Wisconsin |
Profile Details
| NPI number | 1962500728 |
|---|---|
| LBN Legal business name | Borman, Richard J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Feb 10th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962500728 | NPPES |
| Wisconsin | MEDICAID | 30747100 |
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