Provider Demographics
NPI:1386098648
Name:BARTELS, HEATHER BODIFORD (MD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:BODIFORD
Last Name:BARTELS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2423
Mailing Address - Country:US
Mailing Address - Phone:603-668-2020
Mailing Address - Fax:603-668-0881
Practice Address - Street 1:454 OLD STREET RD STE 204
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1200
Practice Address - Country:US
Practice Address - Phone:603-668-2020
Practice Address - Fax:603-668-0881
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH23535207W00000X
TXBP10059626207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology