MEDICARE: STEPHEN J BARTOK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD00031365	WA

General Provider Information

NPI Number	:	1487647020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN J BARTOK MD

Provider Business Mailing Address
First Line	:	581 COOK RD
Second Line	:
City	:	CAMANO ISLAND
State	:	WA
Zip	:	98282-8577
Country	:	US
Telephone Number	:	360-387-4915
Fax Number	:	360-387-4915

Provider Business Practice Location Address
First Line	:	1320 E DIVISION ST
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98274-4133
Country	:	US
Telephone Number	:	360-424-6161
Fax Number	:	360-848-1167

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	07/08/2007

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