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General NPI Number Information
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NPI Number | 1619942232
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Entity Type | Individual
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Provider Name | CARL WILLIAM HARTMAN MD
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Gender | Male
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 12/30/2010
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Provider Practice Location Address
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Address Line | 612 KINGSBOROUGH SQ SUITE 100
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City | CHESAPEAKE
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State | VA
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Zip | 23320-5041
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Country | US
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Telephone | 757-547-9294
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Fax | 757-548-0092
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Provider Business Mailing Address
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Address Line | 5700 CLEVELAND ST SUITE 228
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-1752
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Country | US
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Telephone | 757-499-2825
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Fax | 757-499-4248
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0101026391
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License Number State | VA
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