Provider Demographics
NPI:1568667434
Name:BARTOLOMEI, KEITH R (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:R
Last Name:BARTOLOMEI
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 1:1076 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904
Mailing Address - Country:US
Mailing Address - Phone:401-861-7711
Mailing Address - Fax:401-421-5710
Practice Address - Street 1:1076 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-5760
Practice Address - Country:US
Practice Address - Phone:401-861-7711
Practice Address - Fax:401-421-5710
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD14161207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIKB92869Medicaid
001616504Medicare PIN