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NPI Code Detail

MEDICARE: HALIFAX NEUROLOGY CLINIC, INC

MEDICARE: HALIFAX NEUROLOGY CLINIC, INC
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
1174400000XSpecialist

General Provider Information

NPI Number : 1801909205
Entity Type Code : Organization
Provider Name (Legal Business Name) : HALIFAX NEUROLOGY CLINIC, INC
Provider Business Mailing Address
First Line : 178 EXECUTIVE DR
Second Line :
City : DANVILLE
State : VA
Zip : 24541-4100
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 178 EXECUTIVE DR
Second Line :
City : DANVILLE
State : VA
Zip : 24541-4100
Country : US
Telephone Number : 434-792-3232
Fax Number :
Authorized Official
Title or Position : MD
Name : RAFAEL HURTADO
Credential :
Telephone Number : 434-792-3232
Provider Enumeration Date : 08/17/2006
Last Update Date : 06/14/2011

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Directions to “HALIFAX NEUROLOGY CLINIC, INC ” Practice Location

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