Individual
DR. EDGAR O. HARTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
171 FAIRVIEW RD, MOORESVILLE, NC 28117-9500
(704) 660-4512
(704) 660-4903
Mailing address
PO BOX 49009, GREENWOOD, SC 29649-0001
(864) 223-3070
(864) 223-1396
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
26934
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1227P
BCBS
NC
01
—
26934
NC MEDICAL LICENSE #
NC
05
—
891227P
—
NC
Enumeration date
04/13/2006
Last updated
03/07/2023
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