Mark Bardou, MD

Individual provider Active NPI Emergency Medicine Physician · Linville, NC

NPI 1821138728 · NPPES record last updated Nov 24, 2015

Key facts

NPI
1821138728
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Medicine Physician 207P00000X
License
28124 (NC)
Practice address
434 Hospital Drive
Linville, NC 28646
Phone
(828) 737-7449
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28124NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Linville Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Lexington Medical Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 28124 NC Yes

Addresses

Primary practice location

434 Hospital Drive
Linville, NC 28646

Mailing address

1 Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-1896

Other identifiers

IdentifierTypeStateIssuer
203270FOtherNCMCARE PTAN
891232XMedicaidNC

Other providers in Linville, NC

All providers in Linville, NC · Emergency Medicine Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.