Organization
HARDEE FAMILY MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WAYNE HARDEE MD (OWNER/PRESIDENT)
(704) 658-9779
Entity
Organization
Contact information
Practice address
444 WILLIAMSON RD SUITE E, MOORESVILLE, NC 28117
(704) 658-9779
(704) 658-9773
Mailing address
444 WILLIAMSON RD STE E, MOORESVILLE, NC 28117-9248
(704) 658-9779
(704) 658-9773
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200000816
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34D1027431
CLIA MEDICARE/MEDICAID
NC
05
—
7902629
—
NC
Enumeration date
05/26/2006
Last updated
08/13/2015
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