Individual
BERNARD LAMAR HARDY II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 676-4102
(812) 676-4106
Mailing address
24811 RENSSELAER ST, OAK PARK, MI 48237-1773
(424) 251-1393
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01094213A
IN
390200000X
Student in an Organized Health Care Education/Training Program
4351048740
MI
390200000X
Student in an Organized Health Care Education/Training Program
5315226945
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090541002
MEDICARE PTAN
IN
05
—
300093374
—
IN
Enumeration date
03/12/2018
Last updated
08/26/2024
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