1922043512 NPI number — ADAM A KARTMAN MD

Table of content: ADAM A KARTMAN MD (NPI 1922043512)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922043512 NPI number — ADAM A KARTMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KARTMAN
Provider First Name:
ADAM
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922043512
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2592 KWINA RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLINGHAM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98226-5246
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-384-0464
Provider Business Mailing Address Fax Number:
360-384-2336

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2530 KWINA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98226-9278
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-380-6945
Provider Business Practice Location Address Fax Number:
360-384-2350
Provider Enumeration Date:
06/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  MD00028884 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0401X , with the licence number: MD00028884 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: MD00028884 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8144750 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: BSWA . This is a "1211KA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0227322 . This is a "LIWA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0227320 . This is a "LIWA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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