Provider Demographics
NPI:1710987821
Name:HARDIN, AMY J (MD)
Entity Type:Individual
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First Name:AMY
Middle Name:J
Last Name:HARDIN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:333 SANDY SPRINGS CIR NE
Mailing Address - Street 2:STE 207
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3897
Mailing Address - Country:US
Mailing Address - Phone:404-705-8990
Mailing Address - Fax:404-705-9984
Practice Address - Street 1:1140 HAMMOND DR NE
Practice Address - Street 2:STE E5250
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5338
Practice Address - Country:US
Practice Address - Phone:404-256-2688
Practice Address - Fax:404-256-1820
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-29
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA035307208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00543441HMedicaid
GA00543441GMedicaid