Provider Demographics
NPI:1619942232
Name:HARTMAN, CARL WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:WILLIAM
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 1:5700 CLEVELAND ST
Mailing Address - Street 2:SUITE 228
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1752
Mailing Address - Country:US
Mailing Address - Phone:757-499-2825
Mailing Address - Fax:757-499-4248
Practice Address - Street 1:612 KINGSBOROUGH SQ
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5041
Practice Address - Country:US
Practice Address - Phone:757-547-9294
Practice Address - Fax:757-548-0092
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101026391207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherVA PREMIER
VAPAROtherVHN/P
VAPAROtherUSA MANAGED CARE
NC05718OtherBC/BS NC
VA528969OtherUHC/MAMSI
VA259540OtherANTHEM BCBS
VA428969OtherUHC/MAMSI
VA006092225Medicaid
VA250358OtherANTHEM
VAPAROtherMULTIPLAN
VAPAROtherCORVEL/CORCARE
VA15118OtherOPTIMA/SENTARA
NC8905718Medicaid
VANONOtherFIRST HEALTH
VAPAROtherAETNA
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA15792OtherSENTARA OHP/SHP
VA-001OtherCHAMPUS/TRICARE
VA006010172Medicaid
VAPAROtherCIGNA
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA428969OtherUHC/MAMSI
VAPAROtherAETNA
NC8905718Medicaid
VA006010172Medicaid