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Individual
GEORGE FRED HAZELWOOD III
Active
Individual
GEORGE FRED HAZELWOOD III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
MD8301
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
296936
MAMSI
—
01
—
3264
BLUE CROSS BLUE SHIELD
—
01
—
34571
UNITED HEALTH CARE
—
01
—
850897
UNITED CONCORDIA
—
01
—
D103088
CIGNA
—
Enumeration date
09/05/2006
Last updated
07/08/2007
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