Provider Demographics
NPI:1841495959
Name:BARTHOLOMEW, JOHN F K (MSN APN BC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:F K
Last Name:BARTHOLOMEW
Suffix:
Gender:M
Credentials:MSN APN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 FIRE ROAD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-5857
Mailing Address - Country:US
Mailing Address - Phone:609-407-1220
Mailing Address - Fax:609-407-7149
Practice Address - Street 1:3205 FIRE ROAD
Practice Address - Street 2:SUITE 4
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-5857
Practice Address - Country:US
Practice Address - Phone:609-407-1220
Practice Address - Fax:609-407-7149
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00046400207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
083990AUBMedicare ID - Type Unspecified
Q125170Medicare UPIN