Individual
JONATHAN BORTZ
Active
Individual
JONATHAN BORTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS002640L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040335000
KEYSTONE EAST
PA
01
—
97409
HIGHMARK BLUE SHIELD
PA
Enumeration date
06/05/2006
Last updated
01/29/2010
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