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Individual

DR. CHARLES J HARDEBECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
473 W 12TH AVE, HLRI, 2ND FLOOR, COLUMBUS, OH 43210-1252
(614) 947-3700
(614) 947-3771
Mailing address
700 ACKERMAN RD, SUITE 385, COLUMBUS, OH 43202-1559
(614) 947-3700
(614) 947-3771

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
21052
KY
207RC0000X
Cardiovascular Disease Physician
Primary
35047571
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0545459
OH
05
64210529
KY
Enumeration date
05/23/2005
Last updated
09/17/2010
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