Provider Demographics
NPI:1386608495
Name:HARDY, STUART (MD)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:
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 1:2311 DELANEY RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6012
Mailing Address - Country:US
Mailing Address - Phone:910-762-8754
Mailing Address - Fax:910-762-0778
Practice Address - Street 1:2311 DELANEY RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6012
Practice Address - Country:US
Practice Address - Phone:910-762-8754
Practice Address - Fax:910-762-0778
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00226207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCCD6751OtherRAILROAD MEDICARE
NC01157OtherBLUE CROSS GROUP
NC2052858OtherCIGNA
NC5903877Medicaid
NC189896OtherMEDCOST
NC5902912Medicaid
NC8901157Medicaid
NC2052858OtherCIGNA
NC01157OtherBLUE CROSS GROUP
NC5902912Medicaid