Bonnie J Bartos, PA-C

Individual provider Active NPI Medical Physician Assistant · Wadena, MN

NPI 1003863176 · NPPES record last updated Oct 17, 2016

Key facts

NPI
1003863176
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
9126 (MN)
Practice address
415 Jefferson St North
Tri-County Health Care
Wadena, MN 56482-1296
Phone
(218) 631-3510
Fax
(218) 631-7507
NPI assigned
May 27, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 9126 MN Yes

Addresses

Primary practice location

415 Jefferson St North
Tri-County Health Care
Wadena, MN 56482-1296

Mailing address

415 Jefferson St North
Tri-County Hospital
Wadena, MN 56482-1296
Phone (218) 631-3510

Other identifiers

IdentifierTypeStateIssuer
199583900MedicaidMN

Other providers in Wadena, MN

All providers in Wadena, MN · Medical Physician Assistant in Minnesota

Sources for this page

Verify at the official NPI Registry.