Healthcare Provider Details

I. General information

NPI: 1750712212
Provider Name (Legal Business Name): AARON HOAG R.D., L.D.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 12/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7705 PROSPECTOR PL
RALEIGH NC
27615-6036
US

IV. Provider business mailing address

804 SALEM WOODS DR
RALEIGH NC
27615-3343
US

V. Phone/Fax

Practice location:
  • Phone: 919-413-3129
  • Fax: 704-972-0639
Mailing address:
  • Phone: 919-413-3489
  • Fax: 704-972-0639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL004243
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: