Individual
DR. RUSSELL K HALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 955-7390
Mailing address
PO BOX 64474, BALTIMORE, MD 21264-4474
(410) 550-8551
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
D70510
MD
2085R0001X
Radiation Oncology Physician
V0120
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036171200
—
MD
Enumeration date
01/29/2007
Last updated
02/07/2013
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