Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Aleksandr Bork, DO

Individual provider Psychiatry Physician · NPI 1073204665

Ethan Aleksandr Bork, DO is a Psychiatry Physician in Dearborn, Michigan. Licensed in Michigan. Registered with an NPI since 2023.

Licensed in
MI
In the registry since
2023
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone: (313) 593-7000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 5151016273APP23 (MI)

Record details

NPI number1073204665
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 16, 2023
Last updated in NPPESMay 16, 2023
Certification dateMay 15, 2023
Mailing address15039 Harrison Ave, Allen Park, MI 48101-1806

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