Provider Demographics
NPI:1669447678
Name:HARTMEIER, GINA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:HARTMEIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 EBENEZER RD STE P
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1093
Mailing Address - Country:US
Mailing Address - Phone:803-329-9894
Mailing Address - Fax:803-327-9994
Practice Address - Street 1:2025 EBENEZER RD STE P
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1093
Practice Address - Country:US
Practice Address - Phone:803-329-9894
Practice Address - Fax:803-327-9994
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC306312084P0800X
NJMA060B852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC327877Medicaid
SC306314Medicaid
NJ7788207Medicaid
NJ7788207Medicaid
SC3344Medicare UPIN
NJ023053Medicare ID - Type Unspecified
SC327877Medicaid
SC306314Medicaid