Provider Demographics
NPI:1417954009
Name:HALE, JOHN ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ERIC
Last Name:HALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1515 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1675
Mailing Address - Country:US
Mailing Address - Phone:302-645-3499
Mailing Address - Fax:302-644-4830
Practice Address - Street 1:17388 N VILLAGE MAIN BLVD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-7240
Practice Address - Country:US
Practice Address - Phone:302-291-6050
Practice Address - Fax:833-450-5311
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC1-0003667207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1419775OtherCIGNA
DE4370859OtherAETNA
DE0000319901Medicaid
DE080067313OtherRAILROAD MEDICARE
DE52353201OtherCAREFIRST BCBS MD
DE0510681000OtherAMERIHEALTH
DE0001OtherCAREFIRST BCBS DC
DE15RE30OtherBCBS DE
DE828139OtherMAMSI
DE0000319901Medicaid
DE516519Medicare PIN
DE828139OtherMAMSI