Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 35084120 | OH |
NPI | 1053301671 |
---|---|
Provider Name | Mr. David M Hartman |
First Address | Dover, OH 44622-1970 |
Second Address | Dover, OH 44622-1970 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2005 |
Last Update Date | 02/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2489230 | (05) | OH |
I04804 | (02) | OH |