Provider Demographics
NPI:1265429187
Name:BORGER, WILLIAM P (CRNA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:BORGER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN211915L163W00000X
PA032119367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA03221401OtherCAPITAL ADVANTAGE
PA11766003OtherCAQH
PA1027810090001Medicaid
PA1582763OtherGATEWAY
PA1343180OtherHIGHMARK
PA1343180OtherFIRST PRIORITY
PA2035848000OtherINDEP. BLUE CROSS
PA9869453OtherAETNA
PA1343180OtherKHP CENTRAL
PA82834OtherGEISINGER
PA430070456Medicare PIN
PA9869453OtherAETNA
PA03221401OtherCAPITAL ADVANTAGE