Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | DS029437L | PA |
Y | 204E00000X | Oral & Maxillofacial Surgeon | DS029437L | PA |
NPI | 1043331218 |
---|---|
Provider Name | Dr. Nicholas A. Hatges |
First Address | Drexel Hill, PA 19026-1102 |
Second Address | Drexel Hill, PA 19026-1102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 06/08/2015 |