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General NPI Number Information
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NPI Number | 1639986029
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Entity Type | Individual
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Provider Name | SAMANTHA LEE HALL
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Gender | Female
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 230 WASHINGTON HEIGHTS MED CTR
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City | WESTMINSTER
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State | MD
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Zip | 21157-5633
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Country | US
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Telephone | 410-848-4424
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Fax |
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Provider Business Mailing Address
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Address Line | 1644 SAINT PAUL ST
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City | HAMPSTEAD
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State | MD
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Zip | 21074-2117
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Country | US
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Telephone | 443-986-6267
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | R238860
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | R238860
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License Number State | MD
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