Individual
DR. KEITH D BORTNEM
Active
Individual
DR. KEITH D BORTNEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
7067
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000003721
BLUE CROSS BLUE SHIELD
—
05
—
0094796
—
MT
01
—
0206209
WASHINGTON L&I
—
01
—
200012385
RAILROAD MEDICARE
MT
01
—
810347861
CHAMPUS
MT
01
—
810347861003
EBMS
MT
Enumeration date
06/10/2006
Last updated
04/05/2024
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