Healthcare Provider Details

I. General information

NPI: 1487652392
Provider Name (Legal Business Name): JOHN A HARDING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 06/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CARNIE BLVD SUITE B-5
VOORHEES NJ
08043-4512
US

IV. Provider business mailing address

PO BOX 1710 SOUTH JERSEY RADIOLOGY ASSOCIATES, PA
VOORHEES NJ
08043-7710
US

V. Phone/Fax

Practice location:
  • Phone: 856-751-0123
  • Fax: 856-751-0535
Mailing address:
  • Phone: 856-770-0504
  • Fax: 856-770-0395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA06029800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: