Provider Demographics
NPI:1366726358
Name:DE BORJA, NARCISO A (MD)
Entity type:Individual
Prefix:DR
First Name:NARCISO
Middle Name:A
Last Name:DE BORJA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:406 CHAPELWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2816
Mailing Address - Country:US
Mailing Address - Phone:410-252-6334
Mailing Address - Fax:410-467-3420
Practice Address - Street 1:6615 REISTERSTOWN RD FL 1
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-2686
Practice Address - Country:US
Practice Address - Phone:410-486-2298
Practice Address - Fax:410-358-6551
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0014870207QA0505X, 208D00000X
MDDOO14870207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine