Individual
DR. SCOTT M HALISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3377 MAIN ST, SPRINGFIELD, MA 01107-1111
(413) 734-5661
Mailing address
3377 MAIN ST, SPRINGFIELD, MA 01107-1111
(413) 734-5661
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
75526
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3089193
—
MA
01
—
F21661
UPIN MEDICARE PREVIOUS
MA
Enumeration date
10/05/2005
Last updated
01/25/2008
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