Basic Information
| Provider Information | |||||||||
| NPI: | 1700446051 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARDEE | ||||||||
| FirstName: | JAMAAL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2601 HOLME AVE | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191522096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153356000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2601 HOLME AVE | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191522096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153356000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2019 | ||||||||
| LastUpdateDate: | 07/29/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD477630 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MT218317 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | MD477630 | PA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.