Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | D0088239 | MD |
NPI | 1043530553 |
---|---|
Provider Name | Michael R Hall |
First Address | Baltimore, MD 21264-4226 |
Second Address | Baltimore, MD 21201-1544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2010 |
Last Update Date | 11/10/2019 |