Provider Demographics
NPI:1275530750
Name:HARDER, STEVEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:HARDER
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:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:507-427-3332
Mailing Address - Fax:507-427-2493
Practice Address - Street 1:308 8TH ST N
Practice Address - Street 2:
Practice Address - City:MOUNTAIN LAKE
Practice Address - State:MN
Practice Address - Zip Code:56159-1568
Practice Address - Country:US
Practice Address - Phone:507-427-3332
Practice Address - Fax:507-427-2493
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN26574207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN096282100Medicaid
MN096282100Medicaid
MN080012457Medicare PIN
MN080010025Medicare PIN
MNB41897Medicare UPIN