Provider Demographics
NPI:1326292459
Name:HARDY, JULIA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:ANN
Last Name:HARDY
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 1:776 PENINSULA CT
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2508
Mailing Address - Country:US
Mailing Address - Phone:734-769-5617
Mailing Address - Fax:
Practice Address - Street 1:776 PENINSULA CT
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2508
Practice Address - Country:US
Practice Address - Phone:734-769-5617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010419072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301041907OtherBOARD OF PHARMACY CONTROLLED SUBSTANCE LICENSE