Basic Information
Provider Information
NPI: 1861627903
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BORDERS
FirstName: ELIZABETH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 19305
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282199305
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 110 W GROVER ST
Address2:  
City: SHELBY
State: NC
PostalCode: 281503825
CountryCode: US
TelephoneNumber: 9804872800
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/19/2009
LastUpdateDate: 09/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X2013-00488NCY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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