Provider Demographics
NPI:1558233171
Name:DIMITROV, BORCHE (NP)
Entity type:Individual
Prefix:
First Name:BORCHE
Middle Name:
Last Name:DIMITROV
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 W LIBERTY WAY STE 3
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-5420
Mailing Address - Country:US
Mailing Address - Phone:302-747-7486
Mailing Address - Fax:
Practice Address - Street 1:204 W LIBERTY WAY STE 3
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-5420
Practice Address - Country:US
Practice Address - Phone:302-747-7486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0013421363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily