Individual
LAWRENCE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2332 ALPINE AVE NW, GRAND RAPIDS, MI 49544-1955
(616) 391-8274
Mailing address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 391-8274
(616) 391-8202
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301053192
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0410059
BCBS PIN
MI
01
—
1598712390
GROUP NPI
MI
05
—
4770923
—
MI
05
—
4770988
—
MI
05
—
4771134
—
MI
05
—
4773774
—
MI
05
—
4774000
—
MI
Enumeration date
12/04/2006
Last updated
10/29/2009
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