Provider Demographics
NPI:1285710517
Name:HALL, MICHAEL LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LOUIS
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 E HAMPDEN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2517
Mailing Address - Country:US
Mailing Address - Phone:303-789-6018
Mailing Address - Fax:
Practice Address - Street 1:180 E HAMPDEN AVE STE 100
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2517
Practice Address - Country:US
Practice Address - Phone:303-789-6018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-30
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE32340207V00000X
CO21722207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01217223Medicaid
CO01217223Medicaid
CO72614Medicare PIN