Provider Demographics
NPI:1063513547
Name:BIOCIC, BARTOL (MD)
Entity type:Individual
Prefix:DR
First Name:BARTOL
Middle Name:
Last Name:BIOCIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 W UNIVERSITY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1871
Mailing Address - Country:US
Mailing Address - Phone:248-652-3050
Mailing Address - Fax:
Practice Address - Street 1:1135 W UNIVERSITY DR
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1871
Practice Address - Country:US
Practice Address - Phone:248-652-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBB033484207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI101239OtherCARE CHOICE
MI0635832OtherBCN
MI4717541Medicaid
MI1606358321OtherBCBSM
MIC7727OtherM CARE
MI0635832OtherBCN
MIC7727OtherM CARE