Individual
JEANNIE BORAM UR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
24 JOLIET ST, DYER, IN 46311-1705
(219) 852-1524
(219) 933-2288
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01086395A
IN
207R00000X
Internal Medicine Physician
35.140293
OH
207R00000X
Internal Medicine Physician
57.246226
OH
208M00000X
Hospitalist Physician
Primary
01086395A
IN
208M00000X
Hospitalist Physician
35.140293
OH
Other
Enumeration date
04/12/2018
Last updated
04/21/2025
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