Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ||
Y | 222Z00000X | Podiatrist |
NPI | 1063511855 |
---|---|
Provider Name | Marvin S Hagler |
First Address | Asheville, NC 28801-4103 |
Second Address | Asheville, NC 28801-4103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0486M | BCBS (01) | |
14317 | PARTNERS (01) | |
7701450 | (05) | NC |