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Individual
DIANNA L BORDEWICK
Active
Individual
DIANNA L BORDEWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
41090
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104390165
—
MI
01
—
180043984
RAILROAD
WI
05
—
32562600
—
WI
Enumeration date
06/19/2006
Last updated
08/28/2008
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