Healthcare Provider Details

I. General information

NPI: 1962706770
Provider Name (Legal Business Name): HUNTER HEARN MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2011
Last Update Date: 01/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4111 CAPITOL ST SUITE A
DURHAM NC
27704-2153
US

IV. Provider business mailing address

4111 CAPITOL ST SUITE A
DURHAM NC
27704-2153
US

V. Phone/Fax

Practice location:
  • Phone: 866-499-1588
  • Fax: 919-477-1688
Mailing address:
  • Phone: 866-499-1588
  • Fax: 919-477-1688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number2010-01857
License Number StateNC

VIII. Authorized Official

Name: DR. HUNTER ALVERT HEARN
Title or Position: OWNER / PHYSICIAN
Credential: MD
Phone: 866-499-1588