Provider Demographics
NPI:1679500425
Name:HARDING, SHIRLEY ANN (DO)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:ANN
Last Name:HARDING
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:804 SERVICE RD STE A109F
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-884-2976
Mailing Address - Fax:517-432-3928
Practice Address - Street 1:2900 HANNAH BLVD
Practice Address - Street 2:STE 104
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5384
Practice Address - Country:US
Practice Address - Phone:517-364-8118
Practice Address - Fax:517-364-8119
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2018-10-25
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Provider Licenses
StateLicense IDTaxonomies
MI5101007402208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3509562Medicaid
MA3509562Medicaid
MI0C36082036Medicare PIN