Provider Demographics
NPI:1437349495
Name:MICHAEL J. HARTMAN, MD
Entity Type:Organization
Organization Name:MICHAEL J. HARTMAN, MD
Other - Org Name:KEYSTONE ORTHOPEDIC SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-799-1144
Mailing Address - Street 1:801 MACARTHUR BLVD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2915
Mailing Address - Country:US
Mailing Address - Phone:219-836-4123
Mailing Address - Fax:219-836-0276
Practice Address - Street 1:801 MACARTHUR BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2915
Practice Address - Country:US
Practice Address - Phone:219-836-4123
Practice Address - Fax:219-836-0276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INH07088Medicare UPIN