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General NPI Number Information
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NPI Number | 1669798534
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Entity Type | Individual
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Provider Name | JACOB CAMERON HARTZ MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 1001 BLYTHE BLVD STE 500
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City | CHARLOTTE
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State | NC
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Zip | 28203-5863
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Country | US
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Telephone | 704-373-1813
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Fax | 704-342-5871
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Provider Business Mailing Address
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Address Line | 1001 BLYTHE BLVD STE 500
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City | CHARLOTTE
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State | NC
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Zip | 28203-5863
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Country | US
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Telephone | 704-373-1813
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Fax | 704-342-5871
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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 | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 165196
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License Number State | NC
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