Provider Demographics
NPI:1043217698
Name:BARTOS, DAVID PETER (DPM)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PETER
Last Name:BARTOS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 ABINGTON DR
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1898
Mailing Address - Country:US
Mailing Address - Phone:610-670-2277
Mailing Address - Fax:610-670-5246
Practice Address - Street 1:320 ABINGTON DR
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1898
Practice Address - Country:US
Practice Address - Phone:610-670-2277
Practice Address - Fax:610-670-5246
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001413L213E00000X
FLPO619213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0059639OtherKETSTONE AND SENIOR BLUE
PA01175401OtherCAPITAL BLUE CROSS
PA486556OtherBLUE SHIELD
PA0020417000OtherKEYSTONE EAST
PA01175401OtherCAPITAL BLUE CROSS
PAT27714Medicare UPIN