Provider Demographics
NPI:1548547573
Name:BORAM, ELIZABETH KAE (PA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KAE
Last Name:BORAM
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:29 HOSPITAL PLZ STE C
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-8471
Mailing Address - Country:US
Mailing Address - Phone:304-269-4431
Mailing Address - Fax:304-269-9803
Practice Address - Street 1:29 HOSPITAL PLZ STE C
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-8471
Practice Address - Country:US
Practice Address - Phone:304-269-4431
Practice Address - Fax:304-269-9803
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2021-02-12
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant