Healthcare Provider Details

I. General information

NPI: 1366576522
Provider Name (Legal Business Name): IAN A. HARDING MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 12/29/2022
Certification Date: 12/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 OAK AVE
WORCESTER MA
01605-0000
US

IV. Provider business mailing address

45 OAK AVE
WORCESTER MA
01605-0000
US

V. Phone/Fax

Practice location:
  • Phone: 508-756-2020
  • Fax: 508-756-0705
Mailing address:
  • Phone: 508-756-2020
  • Fax: 508-756-0705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: IAN A HARDING
Title or Position: PEDIATRICIAN
Credential: MD
Phone: 508-756-2020