Healthcare Provider Details

I. General information

NPI: 1821729773
Provider Name (Legal Business Name): SAMUEL HALE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2142 N COVE BLVD
TOLEDO OH
43606-3895
US

IV. Provider business mailing address

2801 W BANCROFT ST
TOLEDO OH
43606-3390
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-4000
  • Fax:
Mailing address:
  • Phone: 800-586-5336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number14225186-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: