Provider Demographics
NPI:1528023702
Name:HALLBERT, DAVID MASON (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MASON
Last Name:HALLBERT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:43 WHITING HILL RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1005
Mailing Address - Country:US
Mailing Address - Phone:207-947-6141
Mailing Address - Fax:207-947-6720
Practice Address - Street 1:302 HUSSON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3374
Practice Address - Country:US
Practice Address - Phone:207-947-6141
Practice Address - Fax:207-947-6720
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2016-12-28
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Provider Licenses
StateLicense IDTaxonomies
MEMD11072207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME338120099Medicaid
ME01521103Medicare PIN