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General NPI Number Information
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NPI Number | 1184735052
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Entity Type | Individual
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Provider Name | FREDERICK T BORTS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/10/2012
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Provider Practice Location Address
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Address Line | 32 JEFFERSON AVE SUITE 109
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City | SHARON
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State | PA
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Zip | 16146-3354
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Country | US
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Telephone | 714-981-6732
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Fax |
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Provider Business Mailing Address
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Address Line | 903 ROBBINS AVENUE
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City | NILES
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State | OH
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Zip | 44446
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Country | US
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Telephone | 330-505-1225
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD6646
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G68310
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD-031970E
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License Number State | PA
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