Provider Demographics
NPI:1871637884
Name:DAVID B. HARDING, MD
Entity Type:Organization
Organization Name:DAVID B. HARDING, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:WURSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-874-4380
Mailing Address - Street 1:PO BOX 1170
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20830-1170
Mailing Address - Country:US
Mailing Address - Phone:301-874-4380
Mailing Address - Fax:301-874-4381
Practice Address - Street 1:602 CENTER ST
Practice Address - Street 2:SUITE 206
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-7420
Practice Address - Country:US
Practice Address - Phone:301-874-4380
Practice Address - Fax:301-260-0738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0035965207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC3696OtherBCBS NATIONAL CAPITAL
MDOH38DBOtherBCBS MARYLAND
MD648871400Medicaid
MDP59303Medicare UPIN
DC3696OtherBCBS NATIONAL CAPITAL