Individual
JOHN ANDREW HALLBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
194 E MAIN ST, FORT KENT, ME 04743-1428
(207) 834-5912
(207) 834-5914
Mailing address
194 E MAIN ST, FORT KENT, ME 04743-1428
(207) 834-5912
(207) 834-5914
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
029044
CT
207X00000X
Orthopaedic Surgery Physician
2010-00313
NC
207X00000X
Orthopaedic Surgery Physician
22726
WV
207X00000X
Orthopaedic Surgery Physician
MD07302
RI
207X00000X
Orthopaedic Surgery Physician
TD131075
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156VW
BCBSNC
NC
05
—
3810008679
—
WV
Enumeration date
02/13/2006
Last updated
06/24/2013
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