Healthcare Provider Details

I. General information

NPI: 1831180942
Provider Name (Legal Business Name): DAVID PETRIE HALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

11945 S JEFFERSON ST
PRINCETON KY
42445-6130
US

V. Phone/Fax

Practice location:
  • Phone: 216-636-5956
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number27037
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: