Doctor Name: | DR. MISS WEDNESDAY HALL |
NPI Number: | 1154582112 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | |
Business Practice Address: | 1819 E Big Beaver Rd Suite 210 Troy, MI - 480832015 |
Business Phone Number: | 2486809000 |
Business Fax Number: | 2486802929 |
Mailing Address: | 1819 E Big Beaver Rd, Suite 210 TROY |
State: | MI |
Postal Code: | 480832015 |
Phone Number: | 2486809000 |
Fax Number: | 2486802929 |
NPI Enumeration Date: | 06/23/2008 |
NPI Last Update Date: | 06/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |