MEDICARE: DR. DUANE HARDY M, TS, MDIV, DMIN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YP1600X	Pastoral Counselor
2	171000000X	Military Health Care Provider
3	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1790545317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUANE HARDY M, TS, MDIV, DMIN

Provider Business Mailing Address
First Line	:	3953 RIVER BLUFFS PL
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-1244
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3953 RIVER BLUFFS PL
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-1244
Country	:	US
Telephone Number	:	804-814-9297
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2024
Last Update Date	:	03/20/2024

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