Provider Demographics
NPI:1962586214
Name:HARDENBERGH, MARLA JO (MEDICAL DOCTOR)
Entity type:Individual
Prefix:DR
First Name:MARLA
Middle Name:JO
Last Name:HARDENBERGH
Suffix:
Gender:F
Credentials:MEDICAL DOCTOR
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Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4901 DAWN DR STE 3200
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28360-8288
Practice Address - Country:US
Practice Address - Phone:910-735-8040
Practice Address - Fax:910-735-8045
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2025-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC200701863207RA0401X
SC36810207V00000X
NC2007-01863207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine