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Organization

ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOSE ANTONIO BARDELAS JR. MD (PRESIDENT)
(336) 883-1393
Entity
Organization

Contact information

Practice address
100 WESTWOOD AVE, HIGH POINT, NC 27262-4320
(336) 883-1393
(336) 883-7517
Mailing address
100 WESTWOOD AVE, HIGH POINT, NC 27262-4320
(336) 883-1393
(336) 883-7517

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0111X
BLUE CROSS BLUE SHIELD
NC
01
2344388
GROUP
NC
01
2344388A
GROUP
NC
01
2344388B
GROUP
NC
05
790111X
NC
Enumeration date
12/06/2006
Last updated
08/12/2010
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