Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 33527 | NC |
NPI | 1013979962 |
---|---|
Provider Name | Dr. Oliver James Hart III |
First Address | Charlotte, NC 28275-1803 |
Second Address | Winston Salem, NC 27103-5846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 08/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
40253 | BCBS ID (01) | NC |
8940253 | (05) | NC |
E1711 | (02) | NC |
P00457721 | RAILROAD MEDICARE (01) | NC |