Provider Demographics
NPI:1578534699
Name:BARTMAN, CASEY R (MD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:R
Last Name:BARTMAN
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:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49083-0250
Mailing Address - Country:US
Mailing Address - Phone:843-844-8188
Mailing Address - Fax:
Practice Address - Street 1:9363 E D AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:MI
Practice Address - Zip Code:49083-9497
Practice Address - Country:US
Practice Address - Phone:629-269-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICB047651207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI101730719Medicaid
MI04113561OtherBLUE CROSS BLUE SHIELD
MICB047651OtherSTATE OF MICHIGAN LICENSE NUMBER