Individual
MS. SUSAN ELAINE BORREGARD
Active
Individual
MS. SUSAN ELAINE BORREGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10000623A
IN
363AS0400X
Surgical Physician Assistant
085001844
IL
363AS0400X
Surgical Physician Assistant
Primary
10000623A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000826050
BCBS
IN
Enumeration date
07/22/2005
Last updated
03/19/2021
Update your record
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