Individual
DR. DOMINIC A. BORGIALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1 HURLEY PLZ, FLINT, MI 48503-5902
(810) 257-9000
(810) 760-0440
Mailing address
1 HURLEY PLZ, 5TH FLOOR S.O.N., FLINT, MI 48503-5902
(810) 762-7038
(810) 760-0440
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101014158
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
5101014158
MI
207Q00000X
Family Medicine Physician
5101014158
MI
208D00000X
General Practice Physician
5101014158
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B51090
BLUE SHIELD
MI
05
—
4542329
—
MI
Enumeration date
09/15/2006
Last updated
05/10/2024
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