# HARDEE FAMILY MEDICINE PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881640035
- **Authorized official:** MICHAEL WAYNE HARDEE MD (OWNER/PRESIDENT)
- **Authorized official phone:** (704) 658-9779

## Contact information

- **Practice address:** 444 WILLIAMSON RD SUITE E, MOORESVILLE, NC 28117
- **Practice address phone:** (704) 658-9779
- **Practice address fax:** (704) 658-9773
- **Mailing address:** 444 WILLIAMSON RD STE E, MOORESVILLE, NC 28117-9248
- **Mailing address phone:** (704) 658-9779
- **Mailing address fax:** (704) 658-9773

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 200000816 | NC | Yes |

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 08/13/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 34D1027431 | CLIA MEDICARE/MEDICAID | NC |
| 05 | — | 7902629 | — | NC |