Individual
DR. BURTON BORON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 EAST BLVD, ELKHART, IN 46514-2483
(574) 389-7362
(574) 389-5612
Mailing address
710 N. NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01035588A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100113460
—
IN
01
—
236040012
MEDICARE PTAN
IN
Enumeration date
07/15/2005
Last updated
08/15/2017
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