Provider Demographics
NPI:1801979711
Name:HALING, JOEL ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ANDREW
Last Name:HALING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 70883
Mailing Address - Street 2:DEPT 777
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28272-0883
Mailing Address - Country:US
Mailing Address - Phone:757-221-7111
Mailing Address - Fax:757-221-8085
Practice Address - Street 1:200 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2227
Practice Address - Country:US
Practice Address - Phone:276-236-8181
Practice Address - Fax:540-236-1715
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCQ19646207P00000X
VA0101248048207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ19646Medicaid
SCG692416988Medicare ID - Type Unspecified
SCQ19646Medicaid