Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | LL29148 | SC |
Y | 2080P0202X | Pediatric Cardiologist | 2013-01224 | NC |
NPI | 1154331148 |
---|---|
Provider Name | Robert James Hartman |
First Address | Charlotte, NC 28275-1069 |
Second Address | Greenville, NC 27834-8944 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1154331148 | (05) | NC |
17902 | BCBSNC (01) | NC |