Provider Demographics
NPI:1730399106
Name:MONA HARDAS MD PC
Entity type:Organization
Organization Name:MONA HARDAS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-720-1790
Mailing Address - Street 1:3353 FLECKENSTEIN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3035
Mailing Address - Country:US
Mailing Address - Phone:810-720-1790
Mailing Address - Fax:810-720-1794
Practice Address - Street 1:3353 FLECKENSTEIN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3035
Practice Address - Country:US
Practice Address - Phone:810-720-1790
Practice Address - Fax:810-720-1794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMH063776207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104400181Medicaid
MI104400181Medicaid
MI0N99330Medicare PIN
MI0N99330001Medicare Oscar/Certification