Provider Demographics
NPI:1427507631
Name:BORGE, GREG (BSCS, PMP)
Entity type:Individual
Prefix:MR
First Name:GREG
Middle Name:
Last Name:BORGE
Suffix:
Gender:M
Credentials:BSCS, PMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 SILVER LN
Mailing Address - Street 2:201
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-7449
Mailing Address - Country:US
Mailing Address - Phone:612-210-0377
Mailing Address - Fax:
Practice Address - Street 1:2326 SILVER LN
Practice Address - Street 2:201
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-7449
Practice Address - Country:US
Practice Address - Phone:612-210-0377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information