Provider Demographics
NPI:1417977349
Name:ARMISTEAD, HAL (DO)
Entity Type:Individual
Prefix:
First Name:HAL
Middle Name:
Last Name:ARMISTEAD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:340 JAKE ALEXANDER BLVD W
Practice Address - Street 2:STE 105
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-1364
Practice Address - Country:US
Practice Address - Phone:704-403-6240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9800769207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12583OtherNC BC/BS
NC8912583Medicaid
SCNC2531Medicaid
NC1417977349Medicaid
NCNC4245FMedicare PIN
NCNC4245BMedicare PIN
NCE25952Medicare UPIN
NC1417977349Medicaid
NCNC4245EMedicare PIN
NC2401155DMedicare PIN
NC2401155FMedicare PIN
NC12583OtherNC BC/BS
NCNC4245CMedicare PIN
NCNC4245GMedicare PIN
NCNC4245AMedicare PIN
NC2401155EMedicare PIN