Provider Demographics
NPI:1891746541
Name:HARDERS, GREGORY P (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:P
Last Name:HARDERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:ONE VANTAGEWAY, SUITE B240
Mailing Address - Street 2:MIDDLE TENNESSEE EMERGENCY PHYSICIANS, PC
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1562
Mailing Address - Country:US
Mailing Address - Phone:615-329-4020
Mailing Address - Fax:615-327-5475
Practice Address - Street 1:1700 MEDICAL CENTER PARKWAY
Practice Address - Street 2:ST. THOMAS RUTHERFORD HOSPITAL
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:39129
Practice Address - Country:US
Practice Address - Phone:615-329-4020
Practice Address - Fax:615-327-5475
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2015-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ28351146D00000X
TN52680207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZG70389Medicare UPIN
AZZ63492Medicare PIN