Organization
MICHAEL A. HARTMAN DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ALAN HARTMAN DPM (OWNER)
(734) 455-3669
Entity
Organization
Contact information
Practice address
12885 NORTHLINE RD, SOUTHGATE, MI 48195-1181
(734) 283-3777
(734) 324-2598
Mailing address
5226 GREEN RD, WEST BLOOMFIELD, MI 48323-2718
(734) 455-3669
(734) 455-3797
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
MH001532
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0Q31660
MEDICARE PLUS BLUE
MI
05
—
2634520
—
MI
01
—
4279630001
NGS ADMINISTAR
MI
01
—
5821404
BLUE CROSS
MI
Enumeration date
02/21/2017
Last updated
02/21/2017
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