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General NPI Number Information
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NPI Number | 1194172759
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Entity Type | Organization
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Legal Business Name | HARTJEN SPINE CARE, LLC
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 08/25/2016
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Provider Practice Location Address
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Address Line | 615 W MACPHAIL RD SUITE 210
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City | BEL AIR
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State | MD
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Zip | 21014-4309
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Country | US
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Telephone | 443-643-2078
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Fax | 443-643-2088
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Provider Business Mailing Address
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Address Line | 615 W MACPHAIL RD SUITE 210
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City | BEL AIR
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State | MD
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Zip | 21014-4309
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Country | US
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Telephone | 443-643-2082
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Fax | 443-643-1537
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES A HARTJEN
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Credential | M.D.
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Telephone | 410-274-4080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | D33378
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License Number State | MD
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