Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 200000650 | NC |
N | 207L00000X | Anesthesiologist | 52031 | KY |
Y | 207L00000X | Anesthesiologist | 52289 | SC |
NPI | 1003804535 |
---|---|
Provider Name | Dr. Bernard Velardo |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-5812 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2005 |
Last Update Date | 01/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300021125 | (05) | IN |
7100577000 | (05) | KY |
89126PT | (05) | NC |
F39396 | (02) | |
K271910-KOHMG | KY MEDICARE (01) | KY |
N00650 | (05) | SC |