Individual
DR. MICHAEL M HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 HOSPITAL AVE, STE 104, DU BOIS, PA 15801-1463
(814) 375-8055
(814) 375-8056
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-6560
(814) 372-2848
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD036517E
PA
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
MD036517E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001132739
—
PA
01
—
591707Q09
MC PTAN
PA
01
—
852695FFU
MC PTAN
PA
Enumeration date
06/10/2005
Last updated
11/13/2019
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