Provider Demographics
NPI:1407391311
Name:HARTMAN, CHRISTOPHER (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WILSON AVE
Mailing Address - Street 2:PO BOX 78
Mailing Address - City:RISING SUN
Mailing Address - State:MD
Mailing Address - Zip Code:21911-2168
Mailing Address - Country:US
Mailing Address - Phone:410-688-2563
Mailing Address - Fax:
Practice Address - Street 1:2755 AUGUSTINE HERMAN HWY
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE CITY
Practice Address - State:MD
Practice Address - Zip Code:21915-1408
Practice Address - Country:US
Practice Address - Phone:410-885-2075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-31
Last Update Date:2016-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA000031246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other