Individual
MARK ROLLO HALVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 WELCH RD, PALO ALTO, CA 94304-1601
(650) 497-8000
Mailing address
725 WELCH RD, PALO ALTO, CA 94304-1601
(650) 497-8000
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
C195815
CA
2085P0229X
Pediatric Radiology Physician
C195815
CA
2085P0229X
Pediatric Radiology Physician
MD445798
PA
2085P0229X
Pediatric Radiology Physician
P8785
TX
2085R0202X
Diagnostic Radiology Physician
Primary
C195815
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121715004
—
TX
05
—
121715008
—
TX
05
—
285250104
—
TX
Enumeration date
07/10/2007
Last updated
08/13/2024
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