Provider Demographics
NPI:1285023374
Name:CHARLES A. BORCHARD, DPM, PLLC
Entity type:Organization
Organization Name:CHARLES A. BORCHARD, DPM, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:BORCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:989-792-7878
Mailing Address - Street 1:2604 W GENESEE AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3951
Mailing Address - Country:US
Mailing Address - Phone:989-792-7878
Mailing Address - Fax:989-792-7773
Practice Address - Street 1:2604 W GENESEE AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3951
Practice Address - Country:US
Practice Address - Phone:989-792-7878
Practice Address - Fax:989-792-7773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001384213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty