Provider Demographics
NPI:1831442326
Name:BARTOSIK, KAROLINA (PA)
Entity type:Individual
Prefix:
First Name:KAROLINA
Middle Name:
Last Name:BARTOSIK
Suffix:
Gender:F
Credentials:PA
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 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12905 ROSEDALE HILL AVE
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3341
Practice Address - Country:US
Practice Address - Phone:704-801-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-21
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-05600363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2224PAMedicaid
NC1831442326Medicaid
NCNCO368CMedicare PIN
SC2224PAMedicaid
NCNCO368GMedicare PIN
NCNCO368EMedicare PIN
NCNCO368DMedicare PIN