Provider Demographics
NPI:1700972163
Name:VANHALE, HARRIET MCMURRIA (MD)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:MCMURRIA
Last Name:VANHALE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 WOODRUFF RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-4105
Mailing Address - Country:US
Mailing Address - Phone:864-233-6338
Mailing Address - Fax:
Practice Address - Street 1:920 WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-4105
Practice Address - Country:US
Practice Address - Phone:864-233-6338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7900207N00000X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0079006Medicaid
SCP00900039OtherRAILROAD MEDICARE
SCP00900039OtherRAILROAD MEDICARE