Provider Demographics
NPI:1437906773
Name:HART, ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:HART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 SIXTH STREET S.W. CANTON, OH 44710
Mailing Address - Street 2:2600 SIXTH STREET S.W.
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44710-1799
Mailing Address - Country:US
Mailing Address - Phone:330-363-9911
Mailing Address - Fax:330-580-5513
Practice Address - Street 1:2600 SIXTH STREET S.W. CANTON, OH 44710
Practice Address - Street 2:2600 SIXTH STREET S.W.
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44710-1799
Practice Address - Country:US
Practice Address - Phone:330-363-9911
Practice Address - Fax:330-580-5513
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-03
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program