Provider Demographics
NPI:1063491686
Name:HALL-CARRINGTON, CECEILA MERRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:CECEILA
Middle Name:MERRIS
Last Name:HALL-CARRINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CECEILA
Other - Middle Name:MERRIS
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8007 GLENSIDE DR
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-7326
Mailing Address - Country:US
Mailing Address - Phone:301-434-1616
Mailing Address - Fax:410-383-3158
Practice Address - Street 1:1501 DIVISION ST
Practice Address - Street 2:TOTAL HEALTH CARE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-3121
Practice Address - Country:US
Practice Address - Phone:410-383-8300
Practice Address - Fax:410-383-3158
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045050174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4322002 01Medicaid
MDC-652-112-298-673OtherDRIVERS LICENSE
DCG58202Medicare UPIN