Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 027822 | GA |
NPI | 1043203854 |
---|---|
Provider Name | Dr. David H. Hafner |
First Address | Woodstock, GA 30189-4881 |
Second Address | Marietta, GA 30060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 22/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000324596A | (05) | GA |
D29650 | (02) | GA |