Provider Demographics
NPI:1952780876
Name:HARDEE, BRADLEY KENT (DO)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:KENT
Last Name:HARDEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3209 COLONIAL DRIVE
Mailing Address - Street 2:FAMILY MEDICINE CENTER
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29063
Mailing Address - Country:US
Mailing Address - Phone:803-434-6113
Mailing Address - Fax:803-434-8478
Practice Address - Street 1:3114 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NC
Practice Address - Zip Code:28610-9609
Practice Address - Country:US
Practice Address - Phone:828-459-7324
Practice Address - Fax:828-459-7500
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL37649207Q00000X
NC2018-02874207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine