Provider Demographics
NPI:1487757928
Name:BARTOSH, ROBERT ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANDREW
Last Name:BARTOSH
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 1:307 E 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015-3208
Mailing Address - Country:US
Mailing Address - Phone:229-271-4656
Mailing Address - Fax:229-271-4654
Practice Address - Street 1:910 N 5TH ST
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-3254
Practice Address - Country:US
Practice Address - Phone:229-276-2286
Practice Address - Fax:229-276-2289
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA037950207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000578124BMedicaid
GA000578124CMedicaid
GA000578124CMedicaid
GAF75644Medicare UPIN
GA511I200011Medicare PIN