Individual
NIKOLA KARLO BARTULICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
105 FAR WEST DR STE 100, SAINT JOSEPH, MO 64506-3514
(816) 271-8115
(816) 271-8104
Mailing address
105 FAR WEST DR STE 100, SAINT JOSEPH, MO 64506-3514
(816) 271-8115
(816) 271-8104
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2007001543
MO
208000000X
Pediatrics Physician
2007001543
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200436660A
—
KS
05
—
204583900
—
MO
01
—
P00459721
RR MEDICARE
MO
Enumeration date
09/02/2006
Last updated
03/17/2018
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