Individual
DAVID CHESTER HALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
80 68TH ST SE, GRAND RAPIDS, MI 49548
(616) 391-8242
(616) 391-8317
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
(616) 391-8242
(616) 391-8317
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
20A16525
CA
207P00000X
Emergency Medicine Physician
Primary
5101020022
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538422159
—
MI
Enumeration date
06/19/2012
Last updated
07/02/2018
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