Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 20971 | SC |
NPI | 1003815259 |
---|---|
Provider Name | Dr. Stanley C Hall |
First Address | Charlotte, NC 28275-1649 |
Second Address | Mt Pleasant, SC 29464-1810 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 29/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G88558 | (02) | SC |
P00930471 | RAILROAD MEDICARE ID-RSFPN (01) | SC |
T50432 | (05) | SC |