Basic Information
Provider Information
NPI: 1114989159
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HALL
FirstName: ALDEN
MiddleName: W
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 MEDICAL CENTER DR
Address2: DHMC, DEPARTMENT OF HOSPITALIST MEDICINE
City: LEBANON
State: NH
PostalCode: 037561000
CountryCode: US
TelephoneNumber: 6036508380
FaxNumber: 6036536110
Practice Location
Address1: 1 MEDICAL CENTER DR
Address2: DHMC, DEPARTMENT OF HOSPITALIST MEDICINE
City: LEBANON
State: NH
PostalCode: 037561000
CountryCode: US
TelephoneNumber: 6036508380
FaxNumber: 6036536110
Other Information
ProviderEnumerationDate: 04/05/2006
LastUpdateDate: 03/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X042-0011120VTN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X14132NHY Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
101233905VT MEDICAID


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