Individual
DR. ELI R HALLAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1964 STATE ST, SUITE 100, NEW ALBANY, IN 47150-4934
(812) 948-1641
(812) 941-0438
Mailing address
1964 STATE ST, SUITE 100, NEW ALBANY, IN 47150-4934
(812) 948-1641
(812) 941-0438
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01025361A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000042312
ANTHEM
IN
05
—
100115500A
—
IN
01
—
351359575
COMMERCIAL
IN
01
—
35135957500
OHIO BUREAU OF WORKERS' C
OH
01
—
I001704
TRICARE /CHAMPUS
IN
Enumeration date
07/28/2005
Last updated
03/15/2011
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