Provider Demographics
NPI:1073507125
Name:HAHN, ANDREW GALLANT (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:GALLANT
Last Name:HAHN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419A MATTHEWS MINT HILL RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-2308
Mailing Address - Country:US
Mailing Address - Phone:704-847-1030
Mailing Address - Fax:704-849-8261
Practice Address - Street 1:1419A MATTHEWS MINT HILL RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-2308
Practice Address - Country:US
Practice Address - Phone:704-847-1030
Practice Address - Fax:704-849-8261
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC652152W00000X
FLOP1475152W00000X
NC1006152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2998844OtherAETNA
NC09347OtherBCBS
09347OtherNC HEALTHCHOICE
2200276OtherUNITED HEALTHCARE
VNC000910OtherAVESIS
NC8909347Medicaid
P00118919OtherRAILROAD MEDICARE
1006OtherCIGNA
2998844OtherAETNA
NC246373BMedicare PIN