Provider Demographics
NPI:1821093006
Name:HNATOV, ANDREJ V (MD)
Entity Type:Individual
Prefix:
First Name:ANDREJ
Middle Name:V
Last Name:HNATOV
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:MANAGED CARE DEPARTMENT
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:801 WH SMITH BLVD
Practice Address - Street 2:CAROLINA RADIATION MEDICINE, PA
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834
Practice Address - Country:US
Practice Address - Phone:252-329-0025
Practice Address - Fax:252-329-0325
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2016-05-02
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Provider Licenses
StateLicense IDTaxonomies
NC2003-003552085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13361OtherBLUE CROSS/BLUE SHIELD
NCC6602OtherMED COST
NC7713451OtherAETNA PROVIDER ID #
NC8913361Medicaid
NCP00612670OtherRAILROAD MEDICARE
NC8033403OtherCIGNA
NCP01619313OtherRR MEDICARE
NC7713451OtherAETNA PROVIDER ID #
NCP00612670OtherRAILROAD MEDICARE
NC8033403OtherCIGNA