Healthcare Provider Details

I. General information

NPI: 1942422472
Provider Name (Legal Business Name): FREDERICK D BARTHOLOMEW MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43097 WOODWARD SUITE 200
BLOOMFIELD HILLS MI
48302
US

IV. Provider business mailing address

43097 WOODWARD SUITE 200
BLOOMFIELD HILLS MI
48302
US

V. Phone/Fax

Practice location:
  • Phone: 248-253-0656
  • Fax: 248-253-9714
Mailing address:
  • Phone: 248-253-0656
  • Fax: 248-253-9714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. FREDERICK D BARTHOLOMEW
Title or Position: CO OWNER
Credential: MD
Phone: 248-253-0656