Provider Demographics
NPI:1801931969
Name:HARDING, LESLIE COLT (MD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:COLT
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 1:12 CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:JAY
Mailing Address - State:ME
Mailing Address - Zip Code:04239
Mailing Address - Country:US
Mailing Address - Phone:207-897-2521
Mailing Address - Fax:207-897-3948
Practice Address - Street 1:12 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:JAY
Practice Address - State:ME
Practice Address - Zip Code:04239
Practice Address - Country:US
Practice Address - Phone:207-897-2521
Practice Address - Fax:207-897-3948
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME9446207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEH0035OtherBLUE SHIELD
MEH0035OtherBLUE SHIELD
B86780Medicare UPIN