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Individual

MICHELLE BARDACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2400 TUCKER AVE NE, ALBUQUERQUE, NM 87131-0001
(505) 272-1734
(505) 272-1736
Mailing address
933 BRADBURY DR SE STE 2222, ALBUQUERQUE, NM 87106-4375
(505) 272-3120

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD20060797
NM

Other

Enumeration date
09/15/2006
Last updated
03/22/2017
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