Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD00036114 | WA |
N | 207R00000X | Internist | MD00036114 | WA |
N | 111NI0900X | Internist | MD00036114 | WA |
NPI | 1144547662 |
---|---|
Provider Name | Dr. John Sherman Hardy JR. |
First Address | Seabeck, WA 98380-9593 |
Second Address | Seabeck, WA 98380-9593 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2010 |
Last Update Date | 23/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S27769 | (02) | WA |