Provider Demographics
NPI:1356340632
Name:BARTELT, MATTHEW STEPHEN (DO)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:STEPHEN
Last Name:BARTELT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 EATON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-1832
Mailing Address - Country:US
Mailing Address - Phone:610-865-1755
Mailing Address - Fax:610-867-5101
Practice Address - Street 1:800 EATON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-1832
Practice Address - Country:US
Practice Address - Phone:610-865-1755
Practice Address - Fax:610-867-5101
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006233L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA716090OtherHIGHMARK BS
0535238OtherAETNA
811786OtherUNITED HEALTHCARE
PA0011874320001Medicaid
110026210OtherR.R. MEDICARE
0535238OtherAETNA
PA716090OtherHIGHMARK BS