MEDICARE: DR. MICHELLE YVETTE HARDAWAY M.D.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	4301047696	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396883484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE YVETTE HARDAWAY M.D.

Provider Business Mailing Address
First Line	:	27920 ORCHARD LAKE RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3733
Country	:	US
Telephone Number	:	248-855-6030
Fax Number	:	248-855-6045

Provider Business Practice Location Address
First Line	:	27920 ORCHARD LAKE RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3733
Country	:	US
Telephone Number	:	248-855-6030
Fax Number	:	248-855-6045

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

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	07/09/2007

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