Provider Demographics
NPI:1083610810
Name:HARTMAN, STUART A (DO)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:A
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 CUMBERLAND ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-5547
Mailing Address - Country:US
Mailing Address - Phone:717-272-1050
Mailing Address - Fax:717-272-1740
Practice Address - Street 1:341 CUMBERLAND ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-5547
Practice Address - Country:US
Practice Address - Phone:717-272-1050
Practice Address - Fax:717-272-1740
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 005144 L2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1035851Medicaid
PAC28376Medicare UPIN
PA1035851Medicaid