Provider Demographics
NPI:1952373862
Name:BARTLETT, DAVID LAWRENCE (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LAWRENCE
Last Name:BARTLETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 E NORTH AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4737
Mailing Address - Country:US
Mailing Address - Phone:833-246-7662
Mailing Address - Fax:412-442-2323
Practice Address - Street 1:314 E NORTH AVE FL 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4737
Practice Address - Country:US
Practice Address - Phone:833-246-7662
Practice Address - Fax:412-442-2323
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044852E208600000X, 2086X0206X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001226030Medicaid
PA001226030Medicaid
PA052978FKYMedicare ID - Type Unspecified