Individual
MARY JEAN HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MEDICAL DOCTOR
Contact information
Practice address
1000 MON HEALTH MEDICAL PARK DR, SUITE 1100, MORGANTOWN, WV 26505-1104
(304) 599-1448
(304) 598-7219
Mailing address
PO BOX 1615, MORGANTOWN, WV 26507-1615
(304) 285-3679
(304) 285-3694
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
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