Healthcare Provider Details

I. General information

NPI: 1417949710
Provider Name (Legal Business Name): MARTIN HANS BARTELS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 E CARONDELET DR STE 335
TUCSON AZ
85710-2157
US

IV. Provider business mailing address

6565 E CARONDELET DR STE 335
TUCSON AZ
85710-2157
US

V. Phone/Fax

Practice location:
  • Phone: 520-722-2022
  • Fax: 520-290-6175
Mailing address:
  • Phone: 520-722-2022
  • Fax: 520-290-6175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number08768
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: