Provider Demographics
NPI:1437137080
Name:HOBSON, HARRY DOUGLAS (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:DOUGLAS
Last Name:HOBSON
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 W GROVER ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3708
Practice Address - Country:US
Practice Address - Phone:704-487-8591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC367322086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC42671OtherBLUE CROSS BLUE SHIELD
NC4543954OtherAETNA
NC1437137080Medicaid
NC8942671Medicaid
SCN36732Medicaid
NC3126927002OtherCIGNA
F55504Medicare UPIN
NC1437137080Medicaid
SCN36732Medicaid