Individual
NICOLE BORGLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(202) 476-3670
Mailing address
6201 GREENLEIGH AVE, BALTIMORE, MD 21220-2004
(410) 933-6423
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD210011815
DC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2020
Last updated
06/22/2026
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