Provider Demographics
NPI:1104966159
Name:BORROMEO, AZAEL (DC)
Entity type:Individual
Prefix:DR
First Name:AZAEL
Middle Name:
Last Name:BORROMEO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8009 CREEDMOOR RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-4393
Mailing Address - Country:US
Mailing Address - Phone:919-846-7246
Mailing Address - Fax:888-633-8962
Practice Address - Street 1:8009 CREEDMOOR RD
Practice Address - Street 2:SUITE 202
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-4393
Practice Address - Country:US
Practice Address - Phone:919-846-7246
Practice Address - Fax:888-633-8962
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9260111N00000X
NC4346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor