Individual
DR. MIHAIL VALERIEV BORISSOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1214 COOLIDGE BLVD, LAFAYETTE, LA 70503-2621
(337) 289-7991
Mailing address
111 SETTLERS TRACE BLVD, APARTMENT 1404, LAFAYETTE, LA 70508-6083
(786) 218-7989
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
MD.204610
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1082961
—
LA
Enumeration date
06/04/2008
Last updated
06/16/2011
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