Individual
MR. BRIAN ALLEN BORCHARDT
Active
Individual
MR. BRIAN ALLEN BORCHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1121
ND
2251P0200X
Pediatric Physical Therapist
6775
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23319
ND BLUE CROSS BLUE SHIELD
ND
05
—
51319
—
ND
01
—
64-05520
AETNA
—
01
—
821945
AMERICAS PPO
—
01
—
9075049
PRIVATE HEALTHCARE SYSTEM
—
01
—
HP50726
HEALTH PARTNERS
—
Enumeration date
01/03/2007
Last updated
07/08/2007
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