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NPI Code Detail

MEDICARE: MR. JAMES M BARTU CRNA

MEDICARE: MR. JAMES M BARTU CRNA
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
1367500000XCertified Registered Nurse Anesthetist55097KS
2367500000XCertified Registered Nurse Anesthetist28198251AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000731643OTHERINANTHEM PROVIDER NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699767871
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES M BARTU CRNA
Provider Business Mailing Address
First Line : PO BOX 78838
Second Line :
City : DETROIT
State : MI
Zip : 48278-0838
Country : US
Telephone Number : 317-528-4800
Fax Number : 317-865-1479
Provider Business Practice Location Address
First Line : 1701 S CREASY LN
Second Line :
City : LAFAYETTE
State : IN
Zip : 47905-4972
Country : US
Telephone Number : 765-502-4917
Fax Number : 765-502-4023
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 10/20/2023

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Directions to “ MR. JAMES M BARTU CRNA” Practice Location

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