Provider Demographics
NPI:1659377620
Name:HARTMAN, MICHAEL G (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:G
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11877 DOUGLAS RD STE 102-272
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4325
Mailing Address - Country:US
Mailing Address - Phone:404-446-4424
Mailing Address - Fax:404-446-4420
Practice Address - Street 1:9635 VENTANA WAY STE 201
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30022-8622
Practice Address - Country:US
Practice Address - Phone:404-446-4424
Practice Address - Fax:404-446-4420
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA033350207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000436015AMedicaid
GA14BDBXCMedicare ID - Type Unspecified
GAA99674Medicare UPIN