Individual
DR. JACK S. BARTOSZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
615 FULMER RD, MISHAWAKA, IN 46544-6911
(574) 252-3085
(574) 252-5906
Mailing address
4455 EDISON LAKES PKWY, UNITY MEDICAL SURGICAL HOSPITAL, MISHAWAKA, IN 46545-1442
(574) 252-3085
(574) 252-5906
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
02001105
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000109340
ANTHEM NUMBER
IN
05
—
100335800A
—
IN
01
—
OA41009
BCBSM
MI
Enumeration date
07/14/2005
Last updated
09/20/2013
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