Basic Information
| Provider Information | |||||||||
| NPI: | 1922412436 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BORMAN | ||||||||
| FirstName: | ZACHARY | ||||||||
| MiddleName: | ANDREW | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10770 COLUMBIA PIKE STE 400 | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209014462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2404855210 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5550 FRIENDSHIP BLVD STE T90 | ||||||||
| Address2: | |||||||||
| City: | CHEVY CHASE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208157313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2407375500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2014 | ||||||||
| LastUpdateDate: | 08/19/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 259811 | MA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RG0100X | D0088971 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.