Provider Demographics
NPI:1962418921
Name:BOROWSKI, GREGORY DANIEL (DPM)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:DANIEL
Last Name:BOROWSKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 628
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-0628
Mailing Address - Country:US
Mailing Address - Phone:304-736-0555
Mailing Address - Fax:304-736-0556
Practice Address - Street 1:6451 FARMDALE RD
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1305
Practice Address - Country:US
Practice Address - Phone:304-736-0555
Practice Address - Fax:304-736-0556
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV00268213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0099693000Medicaid
OH0858237Medicaid
001721425OtherBLUE CROSS BLUE SHIELD
001721425OtherBLUE CROSS BLUE SHIELD
U32725Medicare UPIN