MEDICARE: JULIA EMILY HALL M.D.

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
1	207Q00000X	Family Medicine Physician	4301059412	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184674772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA EMILY HALL M.D.

Provider Business Mailing Address
First Line	:	6910 4 MILE RD NE
Second Line	:
City	:	ADA
State	:	MI
Zip	:	49301-9625
Country	:	US
Telephone Number	:	616-682-9632
Fax Number	:	231-733-0534

Provider Business Practice Location Address
First Line	:	2700 BAKER ST
Second Line	:	3RD FLOOR
City	:	MUSKEGON HEIGHTS
State	:	MI
Zip	:	49444-2157
Country	:	US
Telephone Number	:	231-733-6605
Fax Number	:	231-733-0534

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	07/25/2007

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