Individual
MARCO HALLERBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 882-1411
Mailing address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 882-1411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
066499
GA
207R00000X
Internal Medicine Physician
ME103776
FL
Other
Enumeration date
05/15/2007
Last updated
04/14/2016
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