Individual
CHARLOTTE HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4461 STARKEY RD, SUITE 201, ROANOKE, VA 24018-0620
(540) 345-4946
(540) 982-7164
Mailing address
4461 STARKEY RD, SUITE 201, ROANOKE, VA 24018-0620
(540) 345-4946
(540) 982-7164
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101237238
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861450868
MEDICARE
—
01
—
VVB267B
MEDICARE PTAN
—
Enumeration date
05/02/2006
Last updated
06/29/2015
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