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General NPI Number Information
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NPI Number | 1316925787
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Entity Type | Individual
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Provider Name | SANTA JOAN BARTHOLOMEW MD
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Gender | Female
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 2100 STANTONSBURG RD
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City | GREENVILLE
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State | NC
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Zip | 27834-2818
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Country | US
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Telephone | 252-744-5871
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Fax | 252-744-5759
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Provider Business Mailing Address
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Address Line | PO BOX 751069
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City | CHARLOTTE
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State | NC
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Zip | 28275-1069
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101049567
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 0101049567
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 2012-02313
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 01062804A
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License Number State | IN
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