Provider Demographics
NPI:1730219916
Name:BORST, MISTY LYNNE (MD)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:LYNNE
Last Name:BORST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2702 LIGHTHOUSE PT E
Mailing Address - Street 2:#614
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4759
Mailing Address - Country:US
Mailing Address - Phone:443-413-8100
Mailing Address - Fax:
Practice Address - Street 1:120 SISTER PIERRE DR
Practice Address - Street 2:SUITE 403
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7516
Practice Address - Country:US
Practice Address - Phone:410-823-6408
Practice Address - Fax:443-279-0537
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2011-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD00698922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry