Provider Demographics
NPI:1346505807
Name:HOCHBERG, HOWARD MARTIN (MD)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:MARTIN
Last Name:HOCHBERG
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 1:1712 BOBWHITE LANE
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-4942
Mailing Address - Country:US
Mailing Address - Phone:208-773-5781
Mailing Address - Fax:
Practice Address - Street 1:1712 BOBWHITE LANE
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-4942
Practice Address - Country:US
Practice Address - Phone:208-773-5781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD20483207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
147532Medicare PIN
WAE53793Medicare UPIN