Provider Demographics
NPI:1720742984
Name:HARTMANN, MATTIAS THOMAS NORBERT (PA-C)
Entity type:Individual
Prefix:MR
First Name:MATTIAS
Middle Name:THOMAS NORBERT
Last Name:HARTMANN
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:5501 FORTUNES RIDGE DR STE P
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6102
Mailing Address - Country:US
Mailing Address - Phone:919-391-7202
Mailing Address - Fax:919-391-7203
Practice Address - Street 1:5501 FORTUNES RIDGE DR STE P
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6102
Practice Address - Country:US
Practice Address - Phone:919-391-7202
Practice Address - Fax:919-391-7203
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2025-07-23
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Provider Licenses
StateLicense IDTaxonomies
NC001011812363A00000X
FL9115203363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty