Doctor Name: | DR. PETER SPELLMAN HALT |
NPI Number: | 1396740338 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A76207 |
Business Practice Address: | 914 Pine St Mount Shasta, CA - 960672143 |
Business Phone Number: | 5309269329 |
Business Fax Number: | 5309269855 |
Mailing Address: | Po Box 1380, MOUNT SHASTA |
State: | CA |
Postal Code: | 960671380 |
Phone Number: | 5309269329 |
Fax Number: | 5309269855 |
NPI Enumeration Date: | 06/16/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/18/2006 |
NPI Reactivation Date: | 04/04/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 247100000X |
License Number: | A76207 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |