Individual
DR. MARYBETH HARDWICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
23411 JEFFERSON AVE, SUITE 100, SAINT CLAIR SHORES, MI 48080-1949
(586) 778-4080
(586) 778-6055
Mailing address
PO BOX 673215, DETROIT, MI 48267-3215
(586) 778-4080
(586) 778-6055
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MH404922
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3384323
—
MI
Enumeration date
07/11/2005
Last updated
04/29/2009
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