Provider Demographics
NPI:1285612515
Name:HALL-NDLOVU, BEVERLEY A (MD)
Entity type:Individual
Prefix:DR
First Name:BEVERLEY
Middle Name:A
Last Name:HALL-NDLOVU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 S 2ND ST
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 S 2ND ST STE 4A
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-2542
Practice Address - Country:US
Practice Address - Phone:717-231-8341
Practice Address - Fax:717-231-8705
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053976L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001590583Medicaid
PAG32916Medicare UPIN
PA884775Medicare PIN