Provider Demographics
NPI:1023068582
Name:HALL, DAVID M (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1200 J D ANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3494
Mailing Address - Country:US
Mailing Address - Phone:304-599-3074
Mailing Address - Fax:304-599-1802
Practice Address - Street 1:1000 J D ANDERSON DR
Practice Address - Street 2:SUITE 401
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1238
Practice Address - Country:US
Practice Address - Phone:304-599-3074
Practice Address - Fax:304-599-1802
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2017-10-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV20378208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9975432001OtherCIGNA
WV001719827OtherBLUE CROSS BLUE SHIELD
WV293333OtherMAMSI
WV3002164000Medicaid
WV7634238OtherAETNA
WVH36988Medicare UPIN
WV4050661Medicare ID - Type Unspecified