Provider Demographics
NPI:1407998867
Name:HAGER, DAVID NORTHROP (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:NORTHROP
Last Name:HAGER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64264
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4264
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1830 E MONUMENT ST
Practice Address - Street 2:PULM & CRIT CARE 5TH FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-2100
Practice Address - Country:US
Practice Address - Phone:410-955-3467
Practice Address - Fax:410-955-0036
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0059474207R00000X, 207RP1001X
MDD59474207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD400885500Medicaid
MD400885500Medicaid
MDKR78S973Medicare PIN
MDH75190Medicare UPIN
MDKR66R048Medicare PIN