Healthcare Provider Details

I. General information

NPI: 1275530750
Provider Name (Legal Business Name): STEVEN M HARDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 8TH ST N
MOUNTAIN LAKE MN
56159-1568
US

IV. Provider business mailing address

PO BOX 5074
SIOUX FALLS SD
57117-5074
US

V. Phone/Fax

Practice location:
  • Phone: 507-427-3332
  • Fax: 507-427-2493
Mailing address:
  • Phone: 507-427-3332
  • Fax: 507-427-2493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number26574
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: