Individual
DR. CAMILLE A BORDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1021 W 5TH AVE, GARY, IN 46402-1703
(219) 880-1190
(219) 880-0784
Mailing address
1021 W 5TH AVE, GARY, IN 46402-1703
(219) 880-1190
(219) 880-0784
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01056527
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000262992
ANTHEM PROVIDER ID NO.
IL
05
—
200394130
—
IN
Enumeration date
08/15/2006
Last updated
03/03/2008
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