MEDICARE: EVERETT T. HART 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	207Y00000X	Otolaryngology Physician	D0044237	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	522122846-003	OTHER	MD	CIGNA
2	B5830001	OTHER	DC	CAREFIRST BLUE CROSS BLUE
3	23965001	OTHER	MD	UNITED HEALTHCARE
4	52801003	OTHER	MD	CAREFIRST BLUE CROSS BLUE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598768764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVERETT T. HART M.D.

Provider Business Mailing Address
First Line	:	PO BOX 37086
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21297-3086
Country	:	US
Telephone Number	:	240-439-8812
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 THOMAS JOHNSON DR
Second Line	:	STE B
City	:	FREDERICK
State	:	MD
Zip	:	21702-4895
Country	:	US
Telephone Number	:	301-695-3100
Fax Number	:

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/20/2020

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Directions to “ EVERETT T. HART M.D.” Practice Location

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