Individual provider Active NPI

Stephanie Yvette Borum, M.D.

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1922103324
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0064323 Issued in MD
Practice address
10 N Greene St
Baltimore, MD 21201-1524
Phone
(410) 605-7000
Fax
(410) 605-7873
NPI assigned
Sep 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0064323 MD Primary

Addresses

Primary practice location

10 N Greene St
Baltimore, MD 21201-1524

Mailing address

6802 Averill Rd
Apt. TD
Baltimore, MD 21237-3851
Phone (410) 574-7131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130129000096 MD Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1355524935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0064323MDMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922103324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6802 AVERILL RD",
            "address_2": "APT. TD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373851",
            "telephone_number": "410-574-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011524",
            "telephone_number": "410-605-7000",
            "fax_number": "410-605-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORUM",
        "first_name": "STEPHANIE",
        "middle_name": "YVETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0064323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.