Provider Demographics
NPI:1225115835
Name:HOOVER, ANNETTE MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:MARIE
Last Name:HOOVER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 S LOUDOUN ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3612
Mailing Address - Country:US
Mailing Address - Phone:540-665-0571
Mailing Address - Fax:540-667-7439
Practice Address - Street 1:2017 S LOUDOUN ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3612
Practice Address - Country:US
Practice Address - Phone:540-665-0571
Practice Address - Fax:540-667-7439
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV925OD152W00000X
VA0618001009152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD61586702OtherCAREFIRST BCBS
410044219OtherRAILROAD MEDICARE
WV3101038000Medicaid
U81717Medicare UPIN