Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 20378 | WV |
NPI | 1023068582 |
---|---|
Provider Name | Dr. David M Hall |
First Address | Morgantown, WV 26505-3494 |
Second Address | Morgantown, WV 26505-1238 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 31/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001719827 | BLUE CROSS BLUE SHIELD (01) | WV |
293333 | MAMSI (01) | WV |
3002164000 | (05) | WV |
7634238 | AETNA (01) | WV |
9975432001 | CIGNA (01) | WV |
H36988 | (02) | WV |