Individual
WILEY R HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF NEUROLOGY, WORCESTER, MA 01655-0002
(508) 856-2527
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
2084A2900X
Neurocritical Care Physician
225655
MA
2084N0400X
Neurology Physician
Primary
225655
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2106736
—
MA
Enumeration date
11/23/2005
Last updated
03/07/2022
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