Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301065981 | MI |
N | 111NI0900X | Internist | 4301065981 | MI |
N | 207RG0100X | Gastroenterologist | 4801065981 | MI |
Y | 207RG0300X | Geriatric Medicine | 4801065981 | MI |
NPI | 1134214687 |
---|---|
Provider Name | Dr. Karen Evaline Hall |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-2700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 21/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3414404 | (05) | MI |
G59232 | (02) | MI |