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NPI Code Detail

MEDICARE: SHANE ALEXANDER HALLE HIS

MEDICARE: SHANE ALEXANDER HALLE HIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument Specialist989WV

General Provider Information

NPI Number : 1164781324
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANE ALEXANDER HALLE HIS
Provider Business Mailing Address
First Line : 307 11TH ST
Second Line :
City : ELKINS
State : WV
Zip : 26241-3517
Country : US
Telephone Number : 304-636-1010
Fax Number : 304-636-9877
Provider Business Practice Location Address
First Line : 307 11TH ST
Second Line :
City : ELKINS
State : WV
Zip : 26241-3517
Country : US
Telephone Number : 304-636-1010
Fax Number : 304-636-9877
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2012
Last Update Date : 05/09/2012

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Directions to “ SHANE ALEXANDER HALLE HIS” Practice Location

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