Provider Demographics
NPI:1558589218
Name:BARTELS, INGOLF K (DC)
Entity Type:Individual
Prefix:
First Name:INGOLF
Middle Name:K
Last Name:BARTELS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 N 8TH STREET
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53083-4921
Mailing Address - Country:US
Mailing Address - Phone:920-452-7600
Mailing Address - Fax:920-452-8270
Practice Address - Street 1:2640 N 8TH STREET
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53083-4921
Practice Address - Country:US
Practice Address - Phone:920-452-7600
Practice Address - Fax:920-452-8270
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1389-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI350052379OtherRAILROAD MEDICARE