Provider Demographics
NPI:1194723072
Name:BARTELL, MICHAEL JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:BARTELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S MARKET ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4748
Mailing Address - Country:US
Mailing Address - Phone:717-697-8030
Mailing Address - Fax:717-691-6755
Practice Address - Street 1:1001 S MARKET ST
Practice Address - Street 2:SUITE A
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4748
Practice Address - Country:US
Practice Address - Phone:717-697-8030
Practice Address - Fax:717-691-6755
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001718L111N00000X
PAAJ001718L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA42820OtherHIGHMARK B/S PROVIDER ID
PA1029066OtherASHN PROVIDER ID
PA01443501OtherBLUE CROSS PROVIDER ID
PA0006320520001Medicaid
PA3000100OtherKEYSTONE PROVIDER ID
PA1029066OtherASHN PROVIDER ID
PA0006320520001Medicaid