Provider Demographics
NPI:1053317404
Name:HOVER, KAREN L (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:L
Last Name:HOVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 FRENCH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-5064
Mailing Address - Country:US
Mailing Address - Phone:207-942-2238
Mailing Address - Fax:207-942-1973
Practice Address - Street 1:205 FRENCH ST STE 2
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5064
Practice Address - Country:US
Practice Address - Phone:207-942-2238
Practice Address - Fax:207-942-1973
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013884207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME3219691OtherAETNA HMO
ME276620099Medicaid
MEP00017628OtherRAILROAD MEDICARE
ME046545OtherANTHEM STAR NUMBER
ME276620099Medicaid
MEMM5822Medicare ID - Type Unspecified