Individual
CHARLES DAVID HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
960 JOE FRANK HARRIS PKWY SE, ANESTHESIA DEPT, CARTERSVILLE, GA 30120-2129
(770) 382-1530
Mailing address
2 SOUTH AVE, CARTERSVILLE, GA 30120-3559
(770) 387-0544
(770) 387-0543
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN154037
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00963498A
—
GA
01
—
GRP180
MEDICARE GROUP NUMBER
GA
Enumeration date
03/12/2007
Last updated
07/08/2007
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