Provider Demographics
NPI:1639340862
Name:STEPHEN BARTEE DPM
Entity Type:Organization
Organization Name:STEPHEN BARTEE DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARTEE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:517-423-8999
Mailing Address - Street 1:6510 SPRING MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-5839
Mailing Address - Country:US
Mailing Address - Phone:517-423-8999
Mailing Address - Fax:
Practice Address - Street 1:200 E RUSSELL RD
Practice Address - Street 2:SUITE B
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-2072
Practice Address - Country:US
Practice Address - Phone:517-423-8999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-15
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001036332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5465000Medicare PIN
MI0712950001Medicare NSC