Provider Demographics
NPI:1811993488
Name:HARDY, RONALD D (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:D
Last Name:HARDY
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 1:235 E ROWAN AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1240
Mailing Address - Country:US
Mailing Address - Phone:509-489-2101
Mailing Address - Fax:509-462-4949
Practice Address - Street 1:235 E ROWAN AVE
Practice Address - Street 2:STE 102
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1240
Practice Address - Country:US
Practice Address - Phone:509-489-2101
Practice Address - Fax:509-462-4949
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043503207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8390064Medicaid
WA8802642Medicare PIN
WA1821100132Medicare PIN
WA8390064Medicaid
WA1811993488Medicare PIN