Individual
EMILY ADDISON BARDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4614 COUNTRY CLUB RD, WINSTON SALEM, NC 27104-3520
(336) 716-3787
(336) 716-0222
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-3787
(336) 716-0222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2024-01488
NC
207R00000X
Internal Medicine Physician
MD60871362
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154783314
—
WA
Enumeration date
03/25/2016
Last updated
08/01/2025
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