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Individual
MR. MICHAEL JOHN BORUCKI
Active
Individual
MR. MICHAEL JOHN BORUCKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G6777
TX
207RI0200X
Infectious Disease Physician
G6777
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122949405
—
TX
01
—
756.061.354
TPI-TEXAS PROVIDER ID
TX
Enumeration date
10/12/2005
Last updated
01/14/2013
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