Provider Demographics
NPI:1760496830
Name:BARONDES, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:BARONDES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:301 BOWMAN GRAY DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7204
Mailing Address - Country:US
Mailing Address - Phone:252-758-5800
Mailing Address - Fax:252-758-3226
Practice Address - Street 1:301 BOWMAN GRAY DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7204
Practice Address - Country:US
Practice Address - Phone:252-758-5800
Practice Address - Fax:252-758-3226
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9600856207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-13440Medicaid
NC89-13440Medicaid
NC2224448Medicare ID - Type Unspecified