1477879450 NPI number — DR. UZELIA JOSHEBA HALL M.D.

Table of content: DR. UZELIA JOSHEBA HALL M.D. (NPI 1477879450)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477879450 NPI number — DR. UZELIA JOSHEBA HALL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HALL
Provider First Name:
UZELIA
Provider Middle Name:
JOSHEBA
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:
LOUIS-JACQUES
Provider Other First Name:
UZELIA
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477879450
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10045 BALTIMORE NATIONAL PIKE
Provider Second Line Business Mailing Address:
A7 #1092
Provider Business Mailing Address City Name:
ELLICOTT CITY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21042-7966
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-458-0890
Provider Business Mailing Address Fax Number:
443-541-4748

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10045 BALTIMORE NATIONAL PIKE
Provider Second Line Business Practice Location Address:
A7 #1092
Provider Business Practice Location Address City Name:
ELLICOTT CITY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21042-7966
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-458-0890
Provider Business Practice Location Address Fax Number:
443-541-4748
Provider Enumeration Date:
04/15/2010

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: 2084P0802X , with the licence number:  D0072066 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: D0072066 , 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: 008045376 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: D400092148 . This is a "MEDICARE #" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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