Provider Demographics
NPI:1700882305
Name:HARDIMAN, THOMAS JOSEPH (DPM)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JOSEPH
Last Name:HARDIMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2663
Mailing Address - Country:US
Mailing Address - Phone:508-747-3567
Mailing Address - Fax:508-830-1224
Practice Address - Street 1:116 LONG POND RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2663
Practice Address - Country:US
Practice Address - Phone:508-747-3567
Practice Address - Fax:508-830-1224
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1747213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4386173OtherAETNA PROVIDER ID
MD0041755002OtherCIGNA PROVIDER ID
MA33076OtherHARVARD PILGRIM PROVIDER
MAY70848OtherBLUE CROSSPROVIDER ID
MA716996OtherTUFTS HEALTH PROVIDER ID
MA4386173OtherAETNA PROVIDER ID
MAY70848Medicare ID - Type UnspecifiedMEDICARE ID
MA0570970001Medicare NSC
MA716996OtherTUFTS HEALTH PROVIDER ID