Organization Name: | MARIANAS FOOTCARE CLINIC |
NPI Number: | 1093912495 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TERESA DAMIAN BORJA (DOCTOR) |
Mailing Address: | 425 Chalan San Antonio Pmb 1021 Tamuning |
State: | GU US |
Postal Code: | 969133602 |
Phone Number: | 6716493338 |
Fax Number: | 6716493336 |
NPI Enumeration Date: | 06/28/2007 |
NPI Last Update Date: | 03/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | POD000005 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GU |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |