Individual
MARK BORDENCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5445 MERIDIAN MARKS RD STE 220, ATLANTA, GA 30342-4755
(404) 255-2419
(404) 255-3101
Mailing address
3225 CUMBERLAND BLVD SE, SUITE 900, ATLANTA, GA 30339-6407
(404) 351-2220
(404) 355-5624
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
48488
GA
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
048488
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000873848A
—
GA
Enumeration date
04/13/2006
Last updated
03/07/2019
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