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Individual

MARC BORCHARDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
501 REDMOND RD NW, ANESTHESIOLOGY DEPARTMENT, ROME, GA 30165-1415
(706) 291-0291
Mailing address
7 W BROOK DR SW, ROME, GA 30165-3671
(706) 291-9570

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN131448
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000815944G
GA
05
000815944H
GA
01
P00211515
RAILROAD GEORGIA
GA
Enumeration date
05/31/2006
Last updated
12/03/2008
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