Individual
DR. MICHAEL BORNEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD8759
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04724403
—
HI
01
—
53686
BCBS
HI
01
—
MD8759
QHP/MDX
HI
Enumeration date
07/13/2005
Last updated
03/16/2013
Update your record
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