Provider Demographics
NPI:1841364171
Name:HANSEN, HUNTER JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:HUNTER
Middle Name:JAMES
Last Name:HANSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10344 PARK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-8505
Mailing Address - Country:US
Mailing Address - Phone:704-981-0033
Mailing Address - Fax:980-237-8582
Practice Address - Street 1:10344 PARK RD STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8505
Practice Address - Country:US
Practice Address - Phone:704-981-0033
Practice Address - Fax:980-237-8582
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO0000001545207Q00000X
TNDO000001545207Q00000X
NC9700978207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I087364OtherMEDICARE PTAN
TNTN0143OtherJOHN DEERE
4102165OtherBLUE CARE
E07281Medicare UPIN
TN103I087364OtherMEDICARE PTAN