Provider Demographics
NPI:1114987799
Name:VEREB, BARTHOLOMEW (MD)
Entity Type:Individual
Prefix:DR
First Name:BARTHOLOMEW
Middle Name:
Last Name:VEREB
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 1:5015 MANATEE AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3857
Mailing Address - Country:US
Mailing Address - Phone:941-792-5578
Mailing Address - Fax:941-798-3603
Practice Address - Street 1:5015 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-3857
Practice Address - Country:US
Practice Address - Phone:941-792-5578
Practice Address - Fax:941-798-3603
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME30898207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271852900Medicaid
FL271852900Medicaid
FL79209Medicare ID - Type Unspecified