Provider Demographics
NPI:1033356043
Name:MICHAEL JOSEPH HARTMAN PC
Entity Type:Organization
Organization Name:MICHAEL JOSEPH HARTMAN PC
Other - Org Name:MICHAEL J. HARTMAN, MD, P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:574-294-6080
Mailing Address - Street 1:500 ARCADE AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-2477
Mailing Address - Country:US
Mailing Address - Phone:574-209-4608
Mailing Address - Fax:574-294-6042
Practice Address - Street 1:500 ARCADE AVE STE 110
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-2485
Practice Address - Country:US
Practice Address - Phone:574-294-6080
Practice Address - Fax:574-294-6042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DQ1997OtherRR MEDICARE
DQ1997OtherRR MEDICARE
IN261250Medicare PIN