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Individual
KEVIN J BARDWELL
Active
Individual
KEVIN J BARDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36003
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0118449
MEDICA
MN
05
—
0572149
—
IA
01
—
080163236
RR MEDICARE
—
01
—
105085
UCARE
MN
05
—
204283500
—
MN
01
—
21851
AMERICAS PPO
MN
05
—
32013500
—
WI
01
—
41084933956001C072
CHAMPUS
—
01
—
62B41BA
BCBS
MN
01
—
HP15832
HEALTH PARTNERS
MN
01
—
NA2951006282
PREFERRED ONE
MN
Enumeration date
01/10/2006
Last updated
07/08/2019
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