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General NPI Number Information
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NPI Number | 1285638510
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Entity Type | Individual
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Provider Name | GLENN R HARDY MD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 11/26/2019
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Provider Practice Location Address
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Address Line | 510 IDLEWILD AVE
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City | EASTON
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State | MD
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Zip | 21601-3824
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Country | US
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Telephone | 410-820-8226
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Fax | 410-820-8405
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Provider Business Mailing Address
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Address Line | 510 IDLEWILD AVE STE 200
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City | EASTON
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State | MD
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Zip | 21601-3883
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Country | US
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Telephone | 410-820-8226
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Fax | 410-820-8405
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | D0029690
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License Number State | MD
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