MEDICARE: DR. MATTHEW D HALL MD, MPH

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	2083X0100X	Occupational Medicine Physician	MD042500-E	PA

General Provider Information

NPI Number	:	1710962220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW D HALL MD, MPH

Provider Business Mailing Address
First Line	:	3903 PENSHURST LN
Second Line	:	APT # 304
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-6330
Country	:	US
Telephone Number	:	703-670-3784
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 WILSON BLVD
Second Line	:	SUITE 1100
City	:	ARLINGTON
State	:	VA
Zip	:	22203-1800
Country	:	US
Telephone Number	:	202-493-1226
Fax Number	:	202-493-1739

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

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	07/08/2007

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