Provider Demographics
NPI:1598801516
Name:HOOVER, RUTH DURAND (MD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:DURAND
Last Name:HOOVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RUTH
Other - Middle Name:DURAND
Other - Last Name:HAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3001 KEITH ST NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3713
Mailing Address - Country:US
Mailing Address - Phone:423-473-5029
Mailing Address - Fax:423-339-4833
Practice Address - Street 1:2600 ELMS PLANTATION BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9164
Practice Address - Country:US
Practice Address - Phone:843-764-3500
Practice Address - Fax:843-569-7222
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16596174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC562019268OtherBLUE CROSS BLUE SHIELD
SC165966Medicaid
SCF03368Medicare UPIN
SCF03368 (0282)Medicare ID - Type Unspecified