Provider Demographics
NPI:1699769745
Name:HARDING, ANDREW J (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:HARDING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 791128
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-1128
Mailing Address - Country:US
Mailing Address - Phone:703-391-2030
Mailing Address - Fax:703-273-3943
Practice Address - Street 1:11800 SUNRISE VALLEY DR
Practice Address - Street 2:SUITE 700
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-5300
Practice Address - Country:US
Practice Address - Phone:703-834-1473
Practice Address - Fax:703-318-7463
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101048758207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA05624525Medicaid
080182915OtherRR MEDICARE
080182915OtherRR MEDICARE
VA05624525Medicaid