Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2007-00703 | NC |
Y | 208600000X | Surgeon | 2007-00703 | NC |
N | 2086S0129X | Vascular Surgeon | 2007-00703 | NC |
N | 2086X0206X | Surgical Oncologist | 2007-00703 | NC |
NPI | 1386858165 |
---|---|
Provider Name | Jonathan Andrew Hata |
First Address | Charlotte, NC 28260-2658 |
Second Address | Hickory, NC 28601-5036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 19/09/2014 |