Bornstein, Ethan Reuvan

Bornstein, Ethan Reuvan is an individual health care provider with primary practice located at Po Box Ph , Chinle AZ 86503-8000. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Bornstein, Ethan Reuvan can be contacted via phone (928) 674-7001.

Contact Information

Primary practice address
Po Box Ph Chinle AZ 86503-8000
Phone: (928) 674-7001
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X DR.0058527 Colorado

Profile Details

NPI number 1558789933
LBN Legal business name Bornstein, Ethan Reuvan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2014
Last updated Jan 23rd, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558789933 NPPES
Arizona MEDICAID 1558789933

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