Provider Demographics
NPI:1457702383
Name:BARTHOLOMEW, FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:
Last Name:BARTHOLOMEW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 EL CAMINO REAL STE 116
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3225
Mailing Address - Country:US
Mailing Address - Phone:650-652-8310
Mailing Address - Fax:
Practice Address - Street 1:1720 EL CAMINO REAL STE 116
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3225
Practice Address - Country:US
Practice Address - Phone:650-652-8310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA267576207R00000X
CAA172548207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine