Individual
DR. SHAWN M HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
900 PEELER ST, KALAMAZOO, MI 49008-2300
(269) 345-8618
(269) 345-1508
Mailing address
900 PEELER ST, KALAMAZOO, MI 49008-2300
(269) 345-8618
(269) 345-1508
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
34.008340
OH
207L00000X
Anesthesiology Physician
Primary
5101015562
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000225048
UNISON
OH
01
—
000000533057
ANTHEM
OH
01
—
0583328
BCMH
OH
05
—
2771022
—
OH
01
—
417902
WELLCARE MEDICAID
OH
01
—
751149
BUCKEYE MEDICAID
OH
01
—
9671066
AETNA
OH
Enumeration date
05/24/2007
Last updated
08/12/2008
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