Provider Demographics
NPI:1376568451
Name:HALL, ADAM P (DO)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:P
Last Name:HALL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:811 DEL PRADO BLVD S
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-2666
Mailing Address - Country:US
Mailing Address - Phone:239-360-2638
Mailing Address - Fax:239-360-2701
Practice Address - Street 1:811 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2666
Practice Address - Country:US
Practice Address - Phone:239-302-2697
Practice Address - Fax:239-302-2699
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2018-01-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS10315208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
H85025Medicare UPIN