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NPI Code Detail

MEDICARE: MR. MATTHIAS J HALL C.P.

MEDICARE:  MR. MATTHIAS J HALL  C.P.
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
1224P00000XProsthetist

General Provider Information

NPI Number : 1326346289
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATTHIAS J HALL C.P.
Provider Business Mailing Address
First Line : 380 CLEVELAND PL
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-6529
Country : US
Telephone Number : 757-456-5501
Fax Number : 757-671-7525
Provider Business Practice Location Address
First Line : 380 CLEVELAND PL
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-6529
Country : US
Telephone Number : 757-456-5501
Fax Number : 757-671-7525
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2011
Last Update Date : 03/02/2011

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