Provider Demographics
NPI:1073593679
Name:HALL, ANDREW F (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:F
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:264 ELM ST
Mailing Address - Street 2:SUITE 12
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2857
Mailing Address - Country:US
Mailing Address - Phone:413-586-1100
Mailing Address - Fax:413-584-7062
Practice Address - Street 1:264 ELM ST
Practice Address - Street 2:SUITE 12
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2857
Practice Address - Country:US
Practice Address - Phone:413-586-1100
Practice Address - Fax:413-584-7062
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA50865207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA508651OtherCONNECTICARE
MA10241801OtherCIGNA
MA000000007613OtherBMC HEALTHNET
MA050865OtherTUFTS
MA2093294Medicaid
MA20225OtherHEALTH NEW ENGLAND
MAJ02372OtherBLUE CROSS AND BLUE SHIEL
MA2358507OtherAETNA
MAJ02372Medicare ID - Type Unspecified
MA2093294Medicaid