Bartholomew J Resta, MD | |
203 Earnhart Dr, Edenton, NC 27932-8401 | |
(252) 482-7407 | |
(252) 482-5529 |
Full Name | Bartholomew J Resta |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 203 Earnhart Dr, Edenton, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790727568 | NPI | - | NPPES |
3053045 | Medicaid | TN | |
5909511 | Medicaid | NC | |
148TA | Other | NC | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 2008-00339 (North Carolina) | Primary |
208000000X | Pediatrics | MD0000020791 (Tennessee) | Secondary |
Entity Name | Vidant Medical Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477648731 PECOS PAC ID: 0345343893 Enrollment ID: O20070321000445 |
Entity Name | Outer Banks Professional Services, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891050357 PECOS PAC ID: 3173652096 Enrollment ID: O20100602000156 |
Mailing Address | Practice Location Address |
---|---|
Bartholomew J Resta, MD Po Box 569, Edenton, NC 27932-0569 Ph: (252) 482-7407 | Bartholomew J Resta, MD 203 Earnhart Dr, Edenton, NC 27932-8401 Ph: (252) 482-7407 |
Melanie Dolores Gray Miller, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 203 Earnhart Dr Ste A, Edenton, NC 27932 Phone: 252-482-7407 | |
Dr. Ian Luke Bryan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 18 Old Fish Hatchery Rd, Edenton, NC 27932 Phone: 252-484-9024 Fax: 252-404-8424 | |
Dr. Raid Abo-kamil, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 203 Earnhart Dr, Edenton, NC 27932 Phone: 252-482-7407 Fax: 252-482-5529 |