Provider Demographics
NPI:1972768067
Name:BORDNER, COLE MARTIN (MD)
Entity type:Individual
Prefix:
First Name:COLE
Middle Name:MARTIN
Last Name:BORDNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 TAYLOR STATION RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-4440
Mailing Address - Country:US
Mailing Address - Phone:614-856-0700
Mailing Address - Fax:614-856-0790
Practice Address - Street 1:150 TAYLOR STATION RD
Practice Address - Street 2:SUITE 140
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-4440
Practice Address - Country:US
Practice Address - Phone:614-856-0700
Practice Address - Fax:614-856-0790
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD434495208G00000X
CT047704208G00000X
OH35-120272208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH134100Medicare PIN