Individual
MICHAEL L REARDON
Active
Individual
MICHAEL L REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9801035
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10590
BLUE CROSS
NC
01
—
2259079B
MEDICARE PTAN
NC
05
—
8910590
—
NC
Enumeration date
08/23/2005
Last updated
03/17/2017
Update your record
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