Provider Demographics
NPI:1962491316
Name:CANTER, HALL G JR (MD)
Entity Type:Individual
Prefix:
First Name:HALL
Middle Name:G
Last Name:CANTER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 739
Mailing Address - Street 2:313 NORTH DR
Mailing Address - City:SOMERSET
Mailing Address - State:OH
Mailing Address - Zip Code:43783-0739
Mailing Address - Country:US
Mailing Address - Phone:740-743-2039
Mailing Address - Fax:740-743-1283
Practice Address - Street 1:313 NORTH DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:OH
Practice Address - Zip Code:43783-9555
Practice Address - Country:US
Practice Address - Phone:740-743-2039
Practice Address - Fax:740-743-1283
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35050515C207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0553799Medicaid
A15746Medicare UPIN
OHCA0549794Medicare ID - Type Unspecified