| 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 |
|---|---|
| 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: Medicare Enrolled 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: Medicare Enrolled Practice Location: 203 Earnhart Dr, Edenton, NC 27932 Phone: 252-482-7407 Fax: 252-482-5529 |