Provider Demographics
NPI:1972134765
Name:HALO HEALTH, PC
Entity Type:Organization
Organization Name:HALO HEALTH, PC
Other - Org Name:HALO HEALTH, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MINIOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-369-0977
Mailing Address - Street 1:702 OBERLIN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1357
Mailing Address - Country:US
Mailing Address - Phone:919-830-3224
Mailing Address - Fax:833-908-2350
Practice Address - Street 1:702 OBERLIN RD STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1357
Practice Address - Country:US
Practice Address - Phone:919-830-3224
Practice Address - Fax:833-908-2350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC200400717OtherNC PHYSICIANS LICENSE