Individual
MICHAEL REVERE HALLENBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2505 US HIGHWAY 431, BOAZ, AL 35957-5908
(256) 593-8310
Mailing address
2505 US HIGHWAY 431, BOAZ, AL 35957-5908
(256) 593-8310
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
44718
AL
Other
Enumeration date
05/13/2016
Last updated
11/22/2023
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