Doctor Name: | RUSSELL BARTELS |
NPI Number: | 1306994744 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. , F.A.C.O.G |
License Number: | AZ30114 |
Business Practice Address: | 8752 E Via De Commercio Suite 2 Scottsdale, AZ - 852583396 |
Business Phone Number: | 4804258700 |
Business Fax Number: | 4804258701 |
Mailing Address: | 25815 N 43rd Pl, PHOENIX |
State: | AZ |
Postal Code: | 850508931 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | AZ30114 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |