Provider Demographics
NPI:1023120201
Name:HARDING, NICHOLAS R (MD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:R
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 1:501 PARK HILL DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3377
Mailing Address - Country:US
Mailing Address - Phone:540-372-6737
Mailing Address - Fax:540-372-3510
Practice Address - Street 1:501 PARK HILL DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3377
Practice Address - Country:US
Practice Address - Phone:540-372-6737
Practice Address - Fax:540-372-3510
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190270207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWWT461OtherGROUP
NYW93631OtherGROUP
NYW93631OtherGROUP
NY86G741Medicare PIN