Individual
DR. JOHN PAUL BORREGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 577-4200
(317) 577-9503
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01089017A
IN
207L00000X
Anesthesiology Physician
38006
AZ
207L00000X
Anesthesiology Physician
M8548
TX
207L00000X
Anesthesiology Physician
MD447781
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780745539
MEDICARE RAILROAD
—
01
—
264430G63
MEDICARE PIN
IN
05
—
300070496
—
IN
05
—
355830
—
AZ
Enumeration date
12/13/2006
Last updated
07/24/2023
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