Individual
DR. MICHAEL ANTHONY P BORROMEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
HIGHWAY 1, IHS BOX 165, RED LAKE, MN 56671-0165
(218) 679-3912
(218) 679-0181
Mailing address
24760 HOSPITAL DRIVE, BOX 497, RED LAKE, MN 56671-0165
(218) 679-3912
(218) 679-0181
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
43108
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34G20BO
BC/BS OF MN
MN
05
—
510010100
—
MN
01
—
HSZ009
PART B
MN
01
—
HSZ011
PART B
MN
Enumeration date
07/12/2006
Last updated
11/07/2016
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