Individual
MR. MARK HARTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
285 W 12TH ST, PERU, IN 46970-1653
(765) 472-8000
Mailing address
285 W 12TH ST, PERU, IN 46970-1653
(765) 472-8000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28116235A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100367610
—
IN
Enumeration date
04/19/2006
Last updated
08/10/2011
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