Provider Demographics
NPI:1477879450
Name:HALL, UZELIA JOSHEBA (MD)
Entity Type:Individual
Prefix:DR
First Name:UZELIA
Middle Name:JOSHEBA
Last Name:HALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:UZELIA
Other - Middle Name:J
Other - Last Name:LOUIS-JACQUES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10045 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:A7 #1092
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7966
Mailing Address - Country:US
Mailing Address - Phone:301-458-0890
Mailing Address - Fax:443-541-4748
Practice Address - Street 1:10045 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:A7 #1092
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7966
Practice Address - Country:US
Practice Address - Phone:301-458-0890
Practice Address - Fax:443-541-4748
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00720662084P0802X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008045376Medicaid
CTD400092148OtherMEDICARE #
CT004082286Medicaid
CT008045376Medicaid
CTC01033OtherAPT PTAN MEDICARE
CT008042339Medicaid
CT008022626Medicaid
CT008024427Medicaid
CT008022622Medicaid
CT008039745Medicaid
CT500000315Medicaid
CT004082260Medicaid
CT008003745Medicaid
CT008023170Medicaid
CT004217099Medicaid