Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | L-251714 | MA |
N | 111NI0900X | Internist | L-251714 | MA |
Y | 207RI0200X | Infectious Disease | 0101264971 | VA |
NPI | 1033473590 |
---|---|
Provider Name | John I Hogan |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2012 |
Last Update Date | 31/07/2018 |