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NPI Code Detail

MEDICARE: NANCY ANN HALLO MD

MEDICARE:   NANCY ANN HALLO  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician35060911OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164461828
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY ANN HALLO MD
Provider Business Mailing Address
First Line : 1675 EAST MAIN STREET
Second Line : BOX 328
City : KENT
State : OH
Zip : 44240-5818
Country : US
Telephone Number : 330-593-1049
Fax Number : 330-572-3836
Provider Business Practice Location Address
First Line : 1675 EAST MAIN STREET
Second Line : BOX 328
City : KENT
State : OH
Zip : 44240-5818
Country : US
Telephone Number : 330-593-1049
Fax Number : 330-572-3836
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 07/21/2022

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Directions to “ NANCY ANN HALLO MD” Practice Location

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