Provider Demographics
NPI:1306827589
Name:HARDEBECK, MARGARET M (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:HARDEBECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41014-1743
Mailing Address - Country:US
Mailing Address - Phone:859-261-8040
Mailing Address - Fax:
Practice Address - Street 1:311 STRAIGHT ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-1018
Practice Address - Country:US
Practice Address - Phone:513-559-2236
Practice Address - Fax:513-475-5253
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35047757207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0528852Medicaid
OH0528852Medicaid
OHHA4082751Medicare ID - Type Unspecified