Most Relevant Information
Provider Data
| NPI Number: | 1003483991 |
| Provider Name: | MADISON BESS BAGLEY |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/08/2021 |
| Last Updated: | 04/05/2023 |
Provider Practice Location
2301 ERWIN RD
DURHAM
NC
277054699
Practice Location Phone/Fax
| Phone: | 9196848111 |
| Fax: |
Provider Mailing Location
2301 ERWIN RD
DURHAM
NC
277054699
Provider Mailing Phone/Fax
| Phone: | 9196848111 |
| Fax: |