Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | D33378 | MD |
NPI | 1063416816 |
---|---|
Provider Name | Dr. Charles A. Hartjen |
First Address | Bel Air, MD 21014-4309 |
Second Address | Bel Air, MD 21014-4309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 09/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0285376014 | CIGNA (01) | MD |
1053594010 | NPI TYPE LL (01) | MD |
1619038510 | NPI TYPE II (01) | MD |
3615682 | AETNA HMO (01) | MD |
407041100 | (05) | MD |
4330577 | AETNA PPO (01) | MD |
523068 | MAMSI (01) | MD |
839A | CAREFIRST BCBS (01) | MD |
D76741 | (02) | |
D76741 | (02) | MD |
J7980001 | BLUE CHOICE/FEDERAL BCBS (01) | MD |