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NPI Code Detail

MEDICARE: DONALD J HARDMAN MD PC

MEDICARE: DONALD J HARDMAN MD PC
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
1207R00000XInternal Medicine Physician4301062726MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10B50030OTHERMIBCBSM GROUP

General Provider Information

NPI Number : 1639318892
Entity Type Code : Organization
Provider Name (Legal Business Name) : DONALD J HARDMAN MD PC
Provider Business Mailing Address
First Line : 3755 REMEMBRANCE RD NW
Second Line : STE 1
City : GRAND RAPIDS
State : MI
Zip : 49534-7745
Country : US
Telephone Number : 616-453-4403
Fax Number : 616-453-2815
Provider Business Practice Location Address
First Line : 3499 S LINDEN RD
Second Line : SUITE 2
City : FLINT
State : MI
Zip : 48507-3022
Country : US
Telephone Number : 810-820-8121
Fax Number : 810-820-8335
Authorized Official
Title or Position : OWNER
Name : DONALD J HARDMAN
Credential : MD
Telephone Number : 810-820-8121
Provider Enumeration Date : 02/11/2009
Last Update Date : 01/06/2016

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