Individual
MICHAEL BORTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1761 BEALL AVE STE 102, WOOSTER, OH 44691-2342
(330) 287-2595
(330) 202-3487
Mailing address
2401 S 31ST ST, TEMPLE, TX 76508-0001
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
S7847
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1G3116
MEDICARE
TX
Enumeration date
05/14/2014
Last updated
06/10/2021
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