Individual
DR. LETITIA MARIE HAZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2101 GARNER RD, RALEIGH, NC 27610-0114
(919) 787-6131
(919) 571-2932
Mailing address
PO BOX 696, HAMPSTEAD, NC 28443
(910) 791-6767
(910) 791-8890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200101342
NC
207QA0401X
Addiction Medicine (Family Medicine) Physician
200101342
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130G4
BCBS
NC
05
—
89130G4
—
NC
01
—
P00192377
RR MC
NC
Enumeration date
12/28/2005
Last updated
12/18/2024
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