Bortel, Beau G
Bortel, Beau G is an sole proprietor health care provider with primary practice located at 5757 Monclova Rd Suite 5, Maumee OH 43537-1863. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Bortel, Beau G can be contacted via phone (419) 893-5757.Contact Information
Primary practice address
5757 Monclova Rd Suite 5
Maumee OH 43537-1863
Phone: (419) 893-5757
Fax: (419) 893-5399
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 36003428 | Ohio |
Profile Details
| NPI number | 1952415101 |
|---|---|
| LBN Legal business name | Bortel, Beau G |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 17th, 2006 |
| Last updated | Mar 21st, 2016 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952415101 | NPPES |
| Ohio | MEDICAID | 2678697 | |
| Ohio | Other | P00327423 |
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