Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 44712 | MN |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 2007022052 | MO |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD.204132 | LA |
NPI | 1023096948 |
---|---|
Provider Name | Michael W Hartman |
First Address | New Orleans, LA 70112-2865 |
Second Address | Kenner, LA 70065-2489 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 24/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
205465107 | (05) | MO |
954693600 | (05) | MN |
H65798 | (02) |