Individual
DR. MARK HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MICHIGAN NE, GRAND RAPIDS, MI 49503
(616) 391-1680
Mailing address
2537 MOMENTUM PL, CHICAGO, IL 60689-0001
(616) 975-1845
(616) 285-0846
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
4301406799
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
930078864
RAILROAD MEDICARE
MI
Enumeration date
07/26/2006
Last updated
05/04/2010
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