Individual
MICHAEL WAYNE HARDEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
444 WILLIAMSON ROAD, SUITE E, MOORESVILLE, NC 28117
(704) 658-9779
(704) 658-9773
Mailing address
444 WILLIAMSON ROAD, SUITE E, MOORESVILLE, NC 28117
(704) 658-9779
(704) 658-9773
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2000-00816
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02629
BLUE CROSS BLUE SHEILD
NC
01
—
2281030
MEDICARE PTAN
NC
01
—
3974316
CIGNA
NC
05
—
891267W
—
NC
Enumeration date
10/03/2005
Last updated
01/04/2012
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