Bardack, Richard A

Bardack, Richard A is an individual health care provider with primary practice located at 55 Whitcher St Ne Suite 350, Marietta GA 30060-1155. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Bardack, Richard A can be contacted via phone (770) 424-6893.

Contact Information

Primary practice address
55 Whitcher St Ne Suite 350 Marietta GA 30060-1155
Phone: (770) 424-6893
Fax: (770) 528-9938
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 012782 Georgia

Profile Details

NPI number 1538303409
LBN Legal business name Bardack, Richard A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2009
Last updated Nov 17th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538303409 NPPES
Georgia MEDICAID 000132657L
Georgia MEDICAID 000132657N
Georgia MEDICAID 000132657Q
Georgia MEDICAID 000132657M
Georgia MEDICAID 000132657O
Georgia MEDICAID 000132657P
Georgia MEDICAID 000132657R

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