POALA D. PRUDE-HALL M.D. NPI 1093889503

NPI Information

NPI: 1093889503
Provider Name: POALA D. PRUDE-HALL, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
505 N CLIPPERT ST
LANSING URGENT CARE
LANSING, MI
ZIP 48912
Phone: (517) 333-9200
Get Directions

Poala D. Prude-hall, M.D. is a family medicine in Lansing, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Poala D. Prude-hall, M.D. NPI is 1093889503. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

505 N CLIPPERT ST
LANSING URGENT CARE
LANSING, MI
ZIP 48912-701
Phone: (517) 333-9200
Fax: (517) 333-9201

The NPI 1093889503 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/17/2006 and was last updated on 11/15/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		4301058586	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	080H262390	OTHER		BLUE CROSS-BLUE CROSS
2	0H26239105	MEDICARE ID-TYPE UNSPECIFIED
3	327176910	MEDICAID	MICHIGAN
4	PP058586	OTHER		COMMERCIAL-COMMERCIAL NUMBER
5	PP058586	OTHER		CHAMPUS-CHAMPUS
6	E81470	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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