Provider Demographics
NPI:1093764144
Name:HARTMAN, CRAIG W (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:W
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4722
Mailing Address - Country:US
Mailing Address - Phone:814-946-2846
Mailing Address - Fax:814-946-1273
Practice Address - Street 1:800 CHESTNUT AVE
Practice Address - Street 2:ALTOONA LUNG SPECIALISTS
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4722
Practice Address - Country:US
Practice Address - Phone:814-946-2846
Practice Address - Fax:814-946-1273
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017146E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009806280002Medicaid
PA0009806280002Medicaid
PA091474E9FMedicare ID - Type Unspecified