Individual
DR. JONATHAN MICHAEL HARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Mailing address
915 N ALTADENA AVE, ROYAL OAK, MI 48067-4409
(248) 632-1144
(248) 632-1477
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301081674
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300F361310
BCBS
MI
05
—
5178010
—
MI
05
—
5193830
—
MI
Enumeration date
01/11/2007
Last updated
10/27/2020
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