1093797995 NPI number — DR. DAVID HARTIG M.D.

Table of content: (NPI 1497738447)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093797995 NPI number — DR. DAVID HARTIG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARTIG
Provider First Name:
DAVID
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093797995
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/24/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10155 YORK RD
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
COCKEYSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21030-3352
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-628-2026
Provider Business Mailing Address Fax Number:
410-667-6834

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10155 YORK RD
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
COCKEYSVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21030-3352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-628-2026
Provider Business Practice Location Address Fax Number:
410-667-6834
Provider Enumeration Date:
11/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  D26575 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 823222 . This is a "ALLIANCE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 32364002 . This is a "BLUE CROSS AND BLUE SHIEL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521212174 . This is a "AMERIGROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 25202 . This is a "EMPLOYER HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521212174 . This is a "AMERICAN INTERNATIONAL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0783346 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 36534 . This is a "HEALTH PARTNER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521212174 . This is a "AAA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521212174 . This is a "ACE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521212174 . This is a "AFTRA HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521212174 . This is a "A-G ADMINISTRATORS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521212174 . This is a "AMERIHEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 43146 . This is a "HEALTH ASSURANCE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 323222 . This is a "OPTIUM CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 32364002 . This is a "CARE FIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 823222 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521212174 . This is a "ACCORDIA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521212174 . This is a "ALLSTATE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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