Individual
MARK HAZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2209 S STERLING ST, SUITE 600, MORGANTON, NC 28655-4091
(704) 444-4244
(704) 347-5261
Mailing address
PO BOX 601067, CHARLOTTE, NC 28260-1067
(704) 444-4244
(704) 347-5261
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01039253
IN
207RC0000X
Cardiovascular Disease Physician
Primary
2011-00879
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000087407
ANTHEM
IN
05
—
0822604
—
OH
05
—
100101790
—
IN
01
—
110070255
RAILROAD
—
05
—
1538139779
—
NC
01
—
260690FF
MEDICARE
IN
05
—
5912675
—
NC
01
—
P00783721
RAILROAD
IN
05
—
Q0087J
—
SC
Enumeration date
01/23/2006
Last updated
05/02/2014
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