Provider Demographics
NPI:1366407686
Name:HOGARTY, SUNEYA G (MD)
Entity type:Individual
Prefix:DR
First Name:SUNEYA
Middle Name:G
Last Name:HOGARTY
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 1:2719 GRAVES DR
Mailing Address - Street 2:STE 14
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-4536
Mailing Address - Country:US
Mailing Address - Phone:919-736-4724
Mailing Address - Fax:919-736-1677
Practice Address - Street 1:2719 GRAVES DR
Practice Address - Street 2:STE 14
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4536
Practice Address - Country:US
Practice Address - Phone:984-207-9440
Practice Address - Fax:919-344-0257
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01018174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902106Medicaid
NC140YROtherBCBS
NC140YROtherBCBS
NCH69550Medicare UPIN
NC2046468Medicare PIN