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 1:16044 MOLOKAI DR
Mailing Address - Street 2:
Mailing Address - City:TEGA CAY
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8560
Mailing Address - Country:US
Mailing Address - Phone:803-431-3222
Mailing Address - Fax:
Practice Address - Street 1:2015 AYRSLEY TOWN BLVD STE 202
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-4068
Practice Address - Country:US
Practice Address - Phone:704-280-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2019-022992084P0800X
SC306312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7788207Medicaid
SC306314Medicaid
SC327877Medicaid
NJ7788207Medicaid
SC3344Medicare UPIN
NJ023053Medicare ID - Type Unspecified
SC327877Medicaid
SC306314Medicaid