Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 28092 | NE |
NPI | 1003259680 |
---|---|
Provider Name | Dr. Matthew Hall |
First Address | Chapel Hill, NC 27599-6119 |
Second Address | Chapel Hill, NC 27599-5005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2013 |
Last Update Date | 29/06/2017 |