Individual
DR. STEPHEN CLAYTON HARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST YAW 6, PEDIATRIC GI AND NUTRITION ASSOCIATES, BOSTON, MA 02114
(617) 726-2930
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(888) 644-3248
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
71020
MA
2080P0206X
Pediatric Gastroenterology Physician
Primary
71020
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3085830
—
MA
01
—
726013
TUFTS HEALTH PLAN
MA
01
—
J10861
BCBS MA
MA
Enumeration date
03/11/2006
Last updated
04/12/2013
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