Provider Demographics
NPI:1093797995
Name:HARTIG, DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:HARTIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11121 YORK RD
Mailing Address - Street 2:
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21030-2006
Mailing Address - Country:US
Mailing Address - Phone:410-628-2026
Mailing Address - Fax:410-667-6834
Practice Address - Street 1:11121 YORK RD STE 200
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21030-2006
Practice Address - Country:US
Practice Address - Phone:410-628-2026
Practice Address - Fax:410-667-6834
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD26575207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD32364002OtherCARE FIRST
MD521212174OtherAMERIGROUP
MD521212174OtherALLSTATE
MD25202OtherEMPLOYER HEALTH
MD32364002OtherBLUE CROSS AND BLUE SHIEL
MD36534OtherHEALTH PARTNER
MD43146OtherHEALTH ASSURANCE
MD521212174OtherAMERIHEALTH
MD521212174OtherAFTRA HEALTH
MD521212174OtherACE
MD521212174OtherAMERICAN INTERNATIONAL
MD823222OtherALLIANCE
MD521212174OtherAAA
MD521212174OtherA-G ADMINISTRATORS
MD0783346OtherAETNA
MD521212174OtherACCORDIA
MD323222OtherOPTIUM CHOICE
MD823222OtherMAMSI
MD32364002OtherBLUE CROSS AND BLUE SHIEL
MD521212174OtherAAA