MEDICARE: JOHN HAZEN POST M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	0101033301	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	265829	OTHER	VA	ANTHEM BLUE CROSS BLUE SH

General Provider Information

NPI Number	:	1063489672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN HAZEN POST M.D.

Provider Business Mailing Address
First Line	:	908 E JEFFERSON ST
Second Line	:	SUITE 201
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22902-5375
Country	:	US
Telephone Number	:	434-979-3745
Fax Number	:	434-293-5995

Provider Business Practice Location Address
First Line	:	908 E JEFFERSON ST
Second Line	:	SUITE 201
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22902-5375
Country	:	US
Telephone Number	:	434-979-3745
Fax Number	:	434-293-5995

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	07/08/2007

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