Provider Demographics
NPI:1356444376
Name:BORTMAN, HOWARD STEVEN (DO)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:STEVEN
Last Name:BORTMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31330 NORTHWESTERN HWY STE D
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2560
Mailing Address - Country:US
Mailing Address - Phone:248-918-2337
Mailing Address - Fax:248-579-2406
Practice Address - Street 1:31330 NORTHWESTERN HWY STE D
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334
Practice Address - Country:US
Practice Address - Phone:248-918-2337
Practice Address - Fax:248-579-2406
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012499207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G70766OtherALLIANCE HEALTH AND LIFE
G70766OtherHAP
C5962OtherMCARE
G70766OtherALLIANCE HEALTH AND LIFE
G70766Medicare UPIN