Provider Demographics
NPI:1013906700
Name:HARDMAN, DONALD J (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:HARDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3755 REMEMBRANCE RD NW
Mailing Address - Street 2:STE 1
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49534-7745
Mailing Address - Country:US
Mailing Address - Phone:616-453-4403
Mailing Address - Fax:616-453-2815
Practice Address - Street 1:3499 S LINDEN RD STE 2
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3022
Practice Address - Country:US
Practice Address - Phone:810-820-8121
Practice Address - Fax:810-820-8335
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2019-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301062726207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110138160OtherMETRAHEALTH
MI4516202Medicaid
MI110B510530OtherB LUE CROSS BLUE SHIELD
MIG41734OtherHEALTH ALLIANCE PLAN
MI0802503102OtherBLUE CROSS BLUE SHIELD
MIC5781OtherMCARE
MI5716508OtherAETNA
MI253179OtherHEALTH ADVANTAGE NETWORK
MI110B510530OtherBLUE CARE NETWORK
MI3153084010OtherCIGNA
MI0980010OtherHEALTH PLUS
MIG41734OtherHEALTH NET FEDERAL
MI0B50030OtherBCBSM GROUP
MA253179OtherMCLAREN HEALTH PLAN
MIC5781OtherMCARE
MI4516202Medicaid