Individual
DR. JOHN LOUIS BORMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7910 W JEFFERSON BLVD STE 108, FORT WAYNE, IN 46804-4159
(260) 436-0800
(260) 483-1911
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(239) 236-2775
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01042016
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0959155
—
OH
05
—
100333820
—
IN
05
—
1689645707
—
MI
Enumeration date
01/27/2006
Last updated
12/17/2024
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