Individual
DR. ROBERT MICHAEL HARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1231 W MAIN ST, FREMONT, MI 49412-1484
(231) 924-2700
(231) 924-9255
Mailing address
105 W EXCHANGE ST, SPRING LAKE, MI 49456-2024
(616) 846-0620
(616) 844-6079
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002366
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201249427
TAX ID
MI
01
—
202916337
TAX ID
MI
01
—
204829649
TAX ID
MI
01
—
383628290
TAX ID
MI
01
—
4901002366
STATE LICENSE
MI
05
—
4956685
—
MI
05
—
4964990
—
MI
05
—
5175725
—
MI
01
—
900F111210
BCBS OF MICHIGAN
MI
01
—
900F210170
BCBS OF MICHIGAN
MI
01
—
U37641
UPIN
MI
Enumeration date
09/12/2005
Last updated
04/29/2009
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