Provider Demographics
NPI:1407149495
Name:HARTMAN, STUART JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:JOSEPH
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:252 S 4TH ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-6111
Mailing Address - Country:US
Mailing Address - Phone:717-270-4876
Mailing Address - Fax:717-270-3875
Practice Address - Street 1:252 S 4TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-6111
Practice Address - Country:US
Practice Address - Phone:717-270-4876
Practice Address - Fax:717-270-3875
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS016186207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102903611Medicaid
PA102903611Medicaid