Basic Information
| Provider Information | |||||||||
| NPI: | 1477569275 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARTELS | ||||||||
| FirstName: | MANDIP | ||||||||
| MiddleName: | KAUR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | UPPAL | ||||||||
| OtherFirstName: | MANDIP | ||||||||
| OtherMiddleName: | KAUR | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 8003 | ||||||||
| Address2: | |||||||||
| City: | APPLETON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 549128003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9208305900 | ||||||||
| FaxNumber: | 9207385787 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 RIVERSIDE DR | ||||||||
| Address2: | |||||||||
| City: | WAUPACA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 549811943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152581000 | ||||||||
| FaxNumber: | 7152581632 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2006 | ||||||||
| LastUpdateDate: | 04/12/2016 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 7241 | ND | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207P00000X | 01067181A | IN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | 64347 | WI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207P00000X | 64347 | WI | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.