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Individual

MRS. BRIDGET STINE BONGAARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
707 MEMORIAL BLVD, CONCORD, NC 28025-2975
(704) 403-7050
(704) 403-7059
Mailing address
PO BOX 602344, CHARLOTTE, NC 28260-2344
(704) 403-7050
(704) 403-7059

Taxonomy

Speciality
Code
Description
License number
State
175F00000X
Naturopath
28133
NC
207R00000X
Internal Medicine Physician
Primary
28133
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11176
PARTNERS MEDICARE CHOICE
NC
01
1205616
UNITED HEALTHCARE
NC
01
1639733
CIGNA HEALTHCARE
NC
01
16783
BCBSNC
NC
05
1730159732
NC
01
177664
WELLPATH
NC
01
203598K
MEDICARE PTAN
NC
01
4102703
AETNA
NC
01
8102223
MAMSI
NC
05
8916783
NC
01
A9136
MEDCOST
NC
Enumeration date
01/24/2006
Last updated
08/25/2014
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