MEDICARE: SUSAN M. HARDING MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1689889305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUSAN M. HARDING MD PC

Provider Business Mailing Address
First Line	:	905 N COURT ST
Second Line	:
City	:	QUITMAN
State	:	GA
Zip	:	31643-1362
Country	:	US
Telephone Number	:	229-263-8956
Fax Number	:	229-263-4671

Provider Business Practice Location Address
First Line	:	905 N COURT ST
Second Line	:
City	:	QUITMAN
State	:	GA
Zip	:	31643-1362
Country	:	US
Telephone Number	:	229-263-8956
Fax Number	:	229-263-4671

Authorized Official
Title or Position	:	OFFICE COORDINATOR
Name	:	ELISE B BENTLEY
Credential	:
Telephone Number	:	229-263-8956

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	08/22/2020

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