Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | 200701863 | NC |
Y | 207V00000X | Obstetrician & Gynecologist | 2007-01863 | NC |
N | 207V00000X | Obstetrician & Gynecologist | 36810 | SC |
NPI | 1962586214 |
---|---|
Provider Name | Dr. Marla Jo Hardenbergh |
First Address | Lumberton, NC 28358-3926 |
Second Address | Lumberton, NC 28358-2677 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 08/03/2021 |