Dr. Frederick William Born, D.O.
Family Medicine in Saint Joseph, MI. Individual provider (NPI-1).
NPI number1295735751
StatusActive
Last updated in NPPESOct 27, 2011
Details
- NPI
- 1295735751
- Entity type
- Individual (NPI-1)
- Name
- Dr. Frederick William Born
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 27, 2005
- Last updated
- Oct 27, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 510 100 9712 | MI | Yes |
Practice location
4077 S Cleveland AveSaint Joseph, MI 49085-9513
Phone 269-429-2992 · Fax 269-429-3372
Mailing address
4077 S Cleveland AveSaint Joseph, MI 49085-9513
Phone 269-429-2992 · Fax 269-429-3372
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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