Individual
MICHAEL A. REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3155 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-3903
(336) 970-5300
(336) 970-5298
Mailing address
3010 TRENWEST DR, WINSTON SALEM, NC 27103-3208
(336) 970-5300
(336) 970-5298
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
0101248087
VA
2085N0700X
Neuroradiology Physician
201501881
NC
2085R0202X
Diagnostic Radiology Physician
Primary
201501881
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/29/2008
Last updated
09/14/2016
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