Individual
BRENDA M HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5700 MONROE ST UNIT 301, SYLVANIA, OH 43560-2737
(419) 291-2121
(419) 479-6017
Mailing address
5700 MONROE ST UNIT 301, SYLVANIA, OH 43560-2737
(419) 291-2121
(419) 479-6017
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35064035
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000141209
ANTHEM
OH
01
—
000000217929
ANTHEM
MI
01
—
01872
PHC
OH
01
—
0637659
AETNA
OH
01
—
0997711
BCMH
OH
05
—
0997711
—
OH
01
—
10717
HPM
OH
01
—
12-01238
UHC
OH
01
—
12-03667
UHC
MI
01
—
3505802301
BCBS MI
MI
01
—
370012698
RRMC
OH
01
—
4530886
AETNA
MI
Enumeration date
08/25/2005
Last updated
11/03/2023
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