Organization
SPRINGFIELD SPINE & SPORT, INC.
Active
Other names
MARTIN F. BERTRAM, MD
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA K GOTHARD (OFFICE MANAGER)
(937) 399-8366
Entity
Organization
Contact information
Practice address
4960 MIDDLE URBANA RD, SPRINGFIELD, OH 45503-6040
(937) 399-8366
(937) 399-8379
Mailing address
4960 MIDDLE URBANA RD, SPRINGFIELD, OH 45503-6040
(937) 399-8366
(937) 399-8379
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
35067942
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000038962
ANTHEM
OH
05
—
0110963
—
OH
01
—
389824050015
OHIO BUREAU WORKERS COMP
OH
Enumeration date
11/13/2007
Last updated
04/20/2008
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