Individual
DR. PETER SPELLMAN HALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
914 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-9329
(530) 926-9855
Mailing address
PO BOX 1086, YREKA, CA 96097-1086
(530) 842-7297
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
A76207
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A762070
—
CA
Enumeration date
06/16/2005
Last updated
10/04/2017
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