Individual
MICHAEL HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
102 HIGHLAND AVE SE, SUITE 305, ROANOKE, VA 24013-2256
(540) 985-9832
(540) 224-4421
Mailing address
450 KYLES MILL RD, BUCHANAN, VA 24066-5004
(540) 473-1274
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101-057411
VA
2080P0206X
Pediatric Gastroenterology Physician
Primary
0101-057411
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010097037
—
VA
05
—
010378567
—
VA
05
—
1477525723
—
VA
05
—
6701477
—
VA
Enumeration date
02/02/2006
Last updated
08/16/2011
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