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General NPI Number Information
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NPI Number | 1790245553
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Entity Type | Individual
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Provider Name | MATTHEW RAYMOND HALL DO
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Gender | Male
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 595 WASHINGTON ST
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City | COVENTRY
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State | RI
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Zip | 02816-5476
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Country | US
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Telephone | 401-822-2772
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Fax | 401-821-5260
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Provider Business Mailing Address
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Address Line | 455 TOLL GATE RD
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City | WARWICK
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State | RI
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Zip | 02886-2759
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | DO01157
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License Number State | RI
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