Individual
MARK BARDOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
434 HOSPITAL DRIVE, LINVILLE, NC 28646
(828) 737-7449
Mailing address
1 MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-1896
(336) 716-5438
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
28124
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203270F
MCARE PTAN
NC
05
—
891232X
—
NC
Enumeration date
02/08/2007
Last updated
11/24/2015
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