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Individual

ROY MYRON BORDENICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S.

Contact information

Practice address
7658A BELAIR RD, BALTIMORE, MD 21236-4088
(410) 668-9198
(410) 668-1075
Mailing address
18 OLD PLANTATION WAY, BALTIMORE, MD 21208-6370
(410) 484-1235
(410) 668-1075

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
MD00126
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00061325
PALMETTO RR MEDICARE
MD
Enumeration date
08/19/2005
Last updated
08/28/2008
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