Individual
DR. JAMIE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7436 WOODWARD AVE, DETROIT, MI 48202-3100
(313) 556-9907
(313) 556-9711
Mailing address
5635 W FORT ST, DETROIT, MI 48209-3154
(313) 849-3920
(313) 849-0824
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301063290
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080H262390
BLUE CROSS-BLUE CROSS
—
05
—
339230710
—
MI
01
—
JH063290
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
08/14/2006
Last updated
12/10/2014
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