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Individual

DONATO J BORRILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
615 JOHNNIE DODDS BLVD STE 102, MOUNT PLEASANT, SC 29464-3082
(843) 936-6451
(843) 936-6451
Mailing address
11100 AIRPORT HWY, SWANTON, OH 43558-9374
(419) 466-5512
(419) 710-7035

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
40559
SC
2083A0100X
Aerospace Medicine Physician
Primary
35062153
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000212144
ANTHEM COMMERICAL
OH
01
0847454
MI MEDICAID
MI
05
0847454
OH
01
840000277
OHIO RAILROAD MEDICARE
OH
Enumeration date
06/24/2005
Last updated
07/23/2019
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