Provider Demographics
NPI:1467555789
Name:SREDEN, HAL I (MD)
Entity Type:Individual
Prefix:DR
First Name:HAL
Middle Name:I
Last Name:SREDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 3300
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2653
Mailing Address - Country:US
Mailing Address - Phone:207-373-6490
Mailing Address - Fax:207-373-6491
Practice Address - Street 1:121 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 3300
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2653
Practice Address - Country:US
Practice Address - Phone:207-373-6490
Practice Address - Fax:207-373-6491
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD15732207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM8539Medicare PIN
MEG79764Medicare UPIN
MEMM8539Medicare PIN