Healthcare Provider Details

I. General information

NPI: 1578534699
Provider Name (Legal Business Name): CASEY R BARTMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9363 E D AVE
RICHLAND MI
49083-9497
US

IV. Provider business mailing address

PO BOX 250
RICHLAND MI
49083-0250
US

V. Phone/Fax

Practice location:
  • Phone: 629-269-5090
  • Fax:
Mailing address:
  • Phone: 843-844-8188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberCB047651
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: