Individual
JACINTO V DE BORJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
413 EASTERN BLVD, BALTO, MD 21221
(410) 391-8114
Mailing address
PO BOX 28326, BALTO, MD 21234
(410) 391-8114
(410) 252-4249
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D0014869
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29155
MDIPA
MD
Enumeration date
11/29/2006
Last updated
07/08/2007
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