Provider Demographics
NPI:1417046871
Name:HARDEN, JOAN ANDREA (MD)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:ANDREA
Last Name:HARDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:ANDREA
Other - Last Name:SERUTCHINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1736
Mailing Address - Country:US
Mailing Address - Phone:404-364-7000
Mailing Address - Fax:
Practice Address - Street 1:BOLL MALL PARKWAY
Practice Address - Street 2:KAISER PERMANENTE STONECREST MEDICAL CENTER
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038
Practice Address - Country:US
Practice Address - Phone:678-323-7510
Practice Address - Fax:678-323-7510
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA48640207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H31519Medicare UPIN