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Contact Information

DAVID L HALLER, MD
420 E DIVISION ST
FOND DU LAC, WI54935-4560
 Phone: 920-926-8570
 Fax: 920-926-8923
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
Indicates primary specialty

NPI Profile & details for DAVID L HALLER · (Male)

NPI # 1548214463
Status Active
Credentials MD
Entity Individual
Enumeration date 05/22/2006
Last updated 12/02/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 43137-020
  • WI Medicaid 34061900
Hospital affiliation(s)
  • ST AGNES HSPTL - (Acute Care)
    430 E DIVISON ST
    FOND DU LAC, WI 54935
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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