Provider Demographics
NPI:1912044215
Name:BARTLETT, EVA LEIGH (MD)
Entity Type:Individual
Prefix:DR
First Name:EVA
Middle Name:LEIGH
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:LEIGH
Other - Last Name:HECHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:301 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:MI
Mailing Address - Zip Code:48884
Mailing Address - Country:US
Mailing Address - Phone:989-291-3261
Mailing Address - Fax:989-291-3775
Practice Address - Street 1:303 CONGRESS
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:MI
Practice Address - Zip Code:48884
Practice Address - Country:US
Practice Address - Phone:989-291-5077
Practice Address - Fax:989-291-5348
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301084278207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F76001Medicare Oscar/Certification
MI0F71000OtherBLUE CROSS BLUE SHIELD