Provider Demographics
NPI:1538100755
Name:BARTELS, EDWARD KELLY (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:KELLY
Last Name:BARTELS
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 1:6440 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-1033
Mailing Address - Country:US
Mailing Address - Phone:716-684-5454
Mailing Address - Fax:716-685-9566
Practice Address - Street 1:1430 COLVIN BLVD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14223-1440
Practice Address - Country:US
Practice Address - Phone:716-877-1221
Practice Address - Fax:716-877-1096
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146718207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology