Individual
LESLIE W HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1801 SUNSET DR, COLUMBIA, SC 29203-6803
(803) 434-4100
(803) 434-4155
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
37695
SC
207R00000X
Internal Medicine Physician
R2J99
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128011
BLUE SHIELD/BLUE CHOICE
MO
05
—
202512513
—
MO
01
—
394166
HEALTHLINK
MO
01
—
400639
UNITED HEALTHCARE
MO
05
—
732448
—
SC
Enumeration date
06/01/2006
Last updated
04/23/2021
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