Provider Demographics
NPI:1558376210
Name:CHESTER COUNTY INFECTIOUS DISEASES ASSOCIATES, PC
Entity Type:Organization
Organization Name:CHESTER COUNTY INFECTIOUS DISEASES ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:BARTELS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-383-7505
Mailing Address - Street 1:213 REECEVILLE RD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-1528
Mailing Address - Country:US
Mailing Address - Phone:610-383-7505
Mailing Address - Fax:610-383-7966
Practice Address - Street 1:213 REECEVILLE RD
Practice Address - Street 2:SUITE 12
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-1528
Practice Address - Country:US
Practice Address - Phone:610-383-7505
Practice Address - Fax:610-383-7966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038321E207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC33415Medicare UPIN