Individual
MARY JEAN HALL
Active
Individual
MARY JEAN HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MEDICAL DOCTOR
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20379
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001712123
BCBS
—
05
—
2004673000
—
WV
01
—
P01617603
RAILROAD
WV
Enumeration date
11/20/2006
Last updated
12/14/2016
Update your record
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