Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 200400353 | NC |
N | 207Q00000X | Family Doctor | 200400353 | NC |
N | 207QS0010X | Family Doctor - Sports Medicine | 2004-00353 | NC |
NPI | 1124050026 |
---|---|
Provider Name | William Michael Hart |
First Address | Chapel Hill, NC 27514-4220 |
Second Address | Chapel Hill, NC 27514-4220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 31/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1434H | BCBS (01) | NC |
5904135 | (05) | NC |