Healthcare Provider Details

I. General information

NPI: 1144546276
Provider Name (Legal Business Name): ADAM BUTENSKY BARTLETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 04/09/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PERKINS SQ
AKRON OH
44308-1063
US

IV. Provider business mailing address

1 PERKINS SQ
AKRON OH
44308-1063
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-8050
  • Fax: 330-543-8054
Mailing address:
  • Phone: 330-543-8050
  • Fax: 330-543-8054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number351382232
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License NumberA142673
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: