Provider Demographics
NPI:1124017041
Name:HOSTETTER, ALDEN (MD)
Entity Type:Individual
Prefix:
First Name:ALDEN
Middle Name:
Last Name:HOSTETTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-5512
Mailing Address - Country:US
Mailing Address - Phone:540-433-7306
Mailing Address - Fax:
Practice Address - Street 1:235 CANTRELL AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3248
Practice Address - Country:US
Practice Address - Phone:540-433-4290
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040805207ZB0001X, 207ZC0500X, 207ZH0000X, 207ZP0104X, 207ZP0213X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
Not Answered207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Not Answered207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Not Answered207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology
Not Answered207ZP0213XAllopathic & Osteopathic PhysiciansPathologyPediatric Pathology
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6618600Medicaid
E37325Medicare UPIN