Individual
SUSAN W HARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1493 CAMBRIDGE ST, PRIMARY CARE CENTER, CAMBRIDGE, MA 02139-1047
(617) 665-1068
Mailing address
1493 CAMBRIDGE ST, PRIMARY CARE CENTER, CAMBRIDGE, MA 02139-1047
(617) 665-1068
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
56517
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
56517
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3020924
—
MA
01
—
J06459
BCBS MA
MA
Enumeration date
11/22/2006
Last updated
12/05/2011
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