Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 4214 | ND |
NPI | 1023068699 |
---|---|
Provider Name | Dr. Charles Richard Hartz |
First Address | Fargo, ND 58102-2732 |
Second Address | Fargo, ND 58102-2417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 08/07/2007 |