Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 0101260421 | VI |
NPI | 1780904250 |
---|---|
Provider Name | Gregory H. Hale |
First Address | Richmond, VA 23255-1690 |
Second Address | Richmond, VA 23226-2553 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2010 |
Last Update Date | 22/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1780904250 | (05) | VA |