Doctor Name: | DR. SALLY HALEY |
NPI Number: | 1053338855 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 013740 |
Business Practice Address: | 93 Church Rd Brunswick, ME - 040117306 |
Business Phone Number: | 2077985907 |
Business Fax Number: | 2077295757 |
Mailing Address: | 93 Church Rd, BRUNSWICK |
State: | ME |
Postal Code: | 040117306 |
Phone Number: | 2077985907 |
Fax Number: | 2077295757 |
NPI Enumeration Date: | 07/16/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 013740 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |