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NPI Code Detail

MEDICARE: DR. ANGELA M HALL M.D

MEDICARE: DR. ANGELA M 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
1208000000XPediatrics Physician052946GA

General Provider Information

NPI Number : 1770551400
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA M HALL M.D
Provider Business Mailing Address
First Line : 3389 WALNUT RDG
Second Line :
City : ATLANTA
State : GA
Zip : 30349-1209
Country : US
Telephone Number : 770-774-0480
Fax Number :
Provider Business Practice Location Address
First Line : 868 YORK AVE SW
Second Line :
City : ATLANTA
State : GA
Zip : 30310-2750
Country : US
Telephone Number : 404-752-1438
Fax Number : 404-758-4594
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 07/08/2007

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