Provider Demographics
NPI:1225072861
Name:HARDAWAY, DAVID MADISON (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MADISON
Last Name:HARDAWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3760
Mailing Address - Country:US
Mailing Address - Phone:828-322-4344
Mailing Address - Fax:828-323-8450
Practice Address - Street 1:1202 N CENTER ST
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3760
Practice Address - Country:US
Practice Address - Phone:828-322-4344
Practice Address - Fax:828-323-8450
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33525208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8939177Medicaid
NC8939177Medicaid
NC213694Medicare ID - Type Unspecified