Provider Demographics
NPI:1770662124
Name:HARDING, DAVID E (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:HARDING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 WATERMELON RD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-5174
Mailing Address - Country:US
Mailing Address - Phone:205-366-0221
Mailing Address - Fax:205-366-0342
Practice Address - Street 1:3509 WATERMELON RD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-5174
Practice Address - Country:US
Practice Address - Phone:205-366-0221
Practice Address - Fax:205-366-0342
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12131207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51511664OtherBCBS PROVIDER NUMBER
AL051511664Medicaid
AL080190024OtherMEDICARE RAILROAD
AL529913220Medicaid
AL51511664OtherBCBS PROVIDER NUMBER
AL051511664Medicaid