Individual
BARTHOLOMEW J RESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
203 EARNHART DR, EDENTON, NC 27932-8401
(252) 482-7407
(252) 482-5529
Mailing address
PO BOX 569, EDENTON, NC 27932-0569
(252) 482-7407
(252) 482-5529
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2008-00339
NC
208000000X
Pediatrics Physician
MD0000020791
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
148TA
BCBS
NC
05
—
3053045
—
TN
05
—
5909511
—
NC
Enumeration date
06/13/2006
Last updated
06/04/2021
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