Provider Demographics
NPI:1467653683
Name:HALL, AMI M (DO)
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:M
Last Name:HALL
Suffix:
Gender:F
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 537
Mailing Address - Street 2:
Mailing Address - City:NEWBURY
Mailing Address - State:OH
Mailing Address - Zip Code:44065-0537
Mailing Address - Country:US
Mailing Address - Phone:440-564-5656
Mailing Address - Fax:440-564-5719
Practice Address - Street 1:10780 KINSMAN RD
Practice Address - Street 2:
Practice Address - City:NEWBURY
Practice Address - State:OH
Practice Address - Zip Code:44065-0537
Practice Address - Country:US
Practice Address - Phone:440-564-5656
Practice Address - Fax:440-564-5719
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34008362207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine