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Individual
MICHAEL JOSEPH REARDON
Active
Individual
MICHAEL JOSEPH REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
F1925
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137550314
—
TX
05
—
137550320
—
TX
01
—
8W8515
BLUE CROSS BLUE SHIELD
TX
01
—
P01074938
RR MEDICARE
TX
Enumeration date
07/29/2005
Last updated
11/23/2016
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