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NPI Code Detail

MEDICARE: DR. MELANIE KOZLOWSKI BORTELL DO

MEDICARE: DR. MELANIE KOZLOWSKI BORTELL DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician34010142OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1H014980OTHEROHMEDICARE ID

General Provider Information

NPI Number : 1538324157
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MELANIE KOZLOWSKI BORTELL DO
Provider Business Mailing Address
First Line : PO BOX 933132
Second Line :
City : CLEVELAND
State : OH
Zip : 44193-0036
Country : US
Telephone Number : 330-375-7512
Fax Number : 330-375-3445
Provider Business Practice Location Address
First Line : 1400 S ARLINGTON ST UNIT 38
Second Line :
City : AKRON
State : OH
Zip : 44306-3771
Country : US
Telephone Number : 888-975-9188
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2008
Last Update Date : 12/13/2024

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