Organization
ALLERGY AND ASTHMA CENTER OF NORTH CAROLINA, PA
Active
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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