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General NPI Number Information
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NPI Number | 1992908479
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Entity Type | Organization
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Legal Business Name | DAVID M. HALLBERT, MD LLC
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16 FAHEY ST STE 108
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City | BELFAST
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State | ME
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Zip | 04915-6029
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Country | US
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Telephone | 207-338-5353
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Fax | 207-338-0146
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Provider Business Mailing Address
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Address Line | 16 FAHEY ST STE 108
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City | BELFAST
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State | ME
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Zip | 04915-6029
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Country | US
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Telephone | 207-338-5353
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Fax | 207-338-0146
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID MASON HALLBERT
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Credential | MD
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Telephone | 207-338-5353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R014171
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License Number State | ME
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