Individual
KENNETH R BOREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4040 E MCLELLAN RD UNIT 11, MESA, AZ 85205-3105
(480) 229-2829
Mailing address
4040 E MCLELLAN RD UNIT 11, MESA, AZ 85205-3105
(480) 229-2829
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
12288
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226911
—
AZ
Enumeration date
09/12/2005
Last updated
08/11/2020
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