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General NPI Number Information
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NPI Number | 1154582112
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Entity Type | Individual
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Provider Name | MISS WEDNESDAY HALL D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 32300 NORTHWESTERN HWY STE 200
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-1501
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Country | US
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Telephone | 248-574-9534
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Fax |
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Provider Business Mailing Address
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Address Line | 11012 E 13 MILE RD STE 112
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City | WARREN
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State | MI
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Zip | 48093-2546
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Country | US
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Telephone | 586-459-5592
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 5101020142
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 5101020142
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License Number State | MI
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