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Individual

BEAU G BORTEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
5757 MONCLOVA RD, SUITE 5, MAUMEE, OH 43537-1863
(419) 893-5757
(419) 893-5399
Mailing address
5757 MONCLOVA RD STE 5, MAUMEE, OH 43537-1863
(419) 893-5757
(419) 893-5399

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36003428
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2678697
OH
01
P00327423
RAILROAD MEDICARE
OH
Enumeration date
08/17/2006
Last updated
09/09/2025
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