Individual
DR. JONATHAN D BORNFREUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
106 LANSFORD CT., SUITE 100, MYRTLE BEACH, SC 29588
(843) 293-8850
(843) 293-8860
Mailing address
106 LANSFORD CT., SUITE 100, MYRTLE BEACH, SC 29588
(843) 293-8850
(843) 293-8860
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0708
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
153867800
DEPARTMENT OF LABOR
SC
01
—
193683
MEDCOST
SC
01
—
7198502
CIGNA
SC
01
—
P00057006
RAILROAD MEDICARE
SC
Enumeration date
03/27/2006
Last updated
09/09/2008
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