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General NPI Number Information
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NPI Number | 1942342142
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Entity Type | Individual
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Provider Name | DAVID ROGERS HART PAC
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Gender | Male
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 05/10/2022
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Provider Practice Location Address
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Address Line | 354 FOLLY RD STE 5
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City | CHARLESTON
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State | SC
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Zip | 29412-2594
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Country | US
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Telephone | 843-225-2374
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Fax | 434-591-9238
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Provider Business Mailing Address
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Address Line | 354 FOLLY RD STE 5
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City | CHARLESTON
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State | SC
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Zip | 29412-2594
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Country | US
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Telephone | 843-225-2374
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Fax | 803-536-0998
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | A763FP
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License Number State | SC
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