# FAIRHAVEN OBSTETRICS & GYNECOLOGY, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437183605
- **Authorized official:** GAYLE J BORKOWSKI M.D. (PRESIDENT)
- **Authorized official phone:** (574) 533-0348

## Contact information

- **Practice address:** 1111 LIGHTHOUSE LANE, GOSHEN, IN 46526-3824
- **Practice address phone:** (574) 533-0348
- **Practice address fax:** (574) 533-0277
- **Mailing address:** 1111 LIGHTHOUSE LANE, GOSHEN, IN 46526-3824
- **Mailing address phone:** (574) 533-0348
- **Mailing address fax:** (574) 533-0277

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 363LW0102X | Women's Health Nurse Practitioner | — | NULL | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | — | — |
| 367A00000X | Advanced Practice Midwife | — | NULL | — |
| 367A00000X | Advanced Practice Midwife | — | — | — |

## Other

- **Enumeration date:** 07/11/2006
- **Last updated:** 07/07/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100111950 | — | IN |
| 01 | — | CB5226 | RAILROAD MEDICARE | IN |