Individual
DR. LAUREN MARIE HARDISTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5921 W STATE ROAD 46, BLOOMINGTON, IN 47404-9359
(812) 935-8866
(812) 935-8860
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01066379A
IN
208M00000X
Hospitalist Physician
01066379A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200936080
—
IN
Enumeration date
06/10/2008
Last updated
01/29/2021
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