MEDICARE: DR. SUNEYA G HOGARTY 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	01018	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	140YR	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1366407686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUNEYA G HOGARTY M.D.

Provider Business Mailing Address
First Line	:	2719 GRAVES DR
Second Line	:	STE 14
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-4536
Country	:	US
Telephone Number	:	919-736-4724
Fax Number	:	919-736-1677

Provider Business Practice Location Address
First Line	:	2719 GRAVES DR
Second Line	:	STE 14
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-4536
Country	:	US
Telephone Number	:	984-207-9440
Fax Number	:	919-344-0257

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	12/15/2020

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