Individual
DAVID J HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
185 KIMEL PARK DR STE 201, WINSTON SALEM, NC 27103-6973
(336) 765-6637
(336) 765-6964
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01086467A
IN
207T00000X
Neurological Surgery Physician
2015-01818
NC
207T00000X
Neurological Surgery Physician
35-084642
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221397
UNISON
OH
01
—
000000343715
ANTHEM
OH
01
—
000000523187
ANTHEM
OH
05
—
2501448
—
OH
01
—
363616
WELLCARE MEDICAID
OH
01
—
745364
BUCKEYE MEDICAID
OH
01
—
7710574
AETNA
OH
01
—
P00192443
RAILROAD MEDICARE
OH
01
—
P00412341
RAILROAD MEDICARE
OH
Enumeration date
07/14/2006
Last updated
09/23/2021
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