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Individual

DR. NICHOLAS BANDARENKO III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 TRENT DRIVE, DURHAM, NC 27710-0001
(919) 684-8111
Mailing address
4101 N ROXBORO ST, DURHAM, NC 27704-2121
(919) 684-8111

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
95-01170
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8912952
NC
Enumeration date
10/04/2006
Last updated
02/28/2008
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