Individual
DR. MARK D BORUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
999 N. CURTIS ROAD, SUITE 205, BOISE, ID 83706
(208) 373-1200
(208) 373-1216
Mailing address
999 N. CURTIS ROAD, SUITE 205, BOISE, ID 83706
(208) 373-1200
(208) 373-1216
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M-6032
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010005929
REGENCE BLUE SHIELD
ID
01
—
DA152
BLUE CROSS OF IDAHO
ID
Enumeration date
10/03/2006
Last updated
07/08/2007
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