Individual
MICHAELENE BARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-7086
Mailing address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-7086
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2006015267
MO
208M00000X
Hospitalist Physician
Primary
2006015267
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200403050A
—
KS
01
—
2006015267
STATE LICENSE
MO
05
—
201434701
—
MO
01
—
P00325865
RR MEDICARE
MO
Enumeration date
07/14/2006
Last updated
03/30/2017
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