Provider Demographics
NPI:1447322946
Name:HARDING, DAVID A (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:HARDING
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 1:8200 AVERY RD
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-1650
Mailing Address - Country:US
Mailing Address - Phone:440-526-0860
Mailing Address - Fax:440-526-0538
Practice Address - Street 1:8200 AVERY RD
Practice Address - Street 2:
Practice Address - City:BROADVIEW HTS
Practice Address - State:OH
Practice Address - Zip Code:44147-1650
Practice Address - Country:US
Practice Address - Phone:440-526-0860
Practice Address - Fax:440-526-0538
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.002009213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5280640001Medicare NSC
OHT80511Medicare UPIN
OH0494951Medicare PIN