1063491686 NPI number — DR. CECEILA MERRIS HALL-CARRINGTON M.D.

Table of content: DR. CECEILA MERRIS HALL-CARRINGTON M.D. (NPI 1063491686)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063491686 NPI number — DR. CECEILA MERRIS HALL-CARRINGTON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HALL-CARRINGTON
Provider First Name:
CECEILA
Provider Middle Name:
MERRIS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HALL
Provider Other First Name:
CECEILA
Provider Other Middle Name:
MERRIS
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1063491686
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8007 GLENSIDE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAKOMA PARK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20912-7326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-434-1616
Provider Business Mailing Address Fax Number:
410-383-3158

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1501 DIVISION ST
Provider Second Line Business Practice Location Address:
TOTAL HEALTH CARE
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21217-3121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-383-8300
Provider Business Practice Location Address Fax Number:
410-383-3158
Provider Enumeration Date:
01/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  D0045050 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4322002 01 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: C-652-112-298-673 . This is a "DRIVERS LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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