Individual
AMY E BULLENS-BORROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1270 FRIENDSHIP RD, BRASELTON, GA 30517-5630
(678) 207-4477
(678) 207-4478
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 535-7445
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
056413
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01417999
AMERIGROUP
GA
01
—
2672603
CIGNA
GA
05
—
310272239C
—
GA
05
—
310272239D
—
GA
05
—
310272239E
—
GA
05
—
310272239F
—
GA
05
—
310272239G
—
GA
01
—
52176459
BCBS
GA
01
—
587774
WELLCARE
GA
01
—
7337297
AETNA
GA
01
—
P00956721
MEDICARE RAILROAD GROUP #CC4177
GA
Enumeration date
07/31/2006
Last updated
02/27/2019
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