Provider Demographics
NPI:1780645952
Name:PINOVER, WAYNE HOWARD (DO)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:HOWARD
Last Name:PINOVER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:PO BOX 13700-1132
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19191-0001
Mailing Address - Country:US
Mailing Address - Phone:888-425-4497
Mailing Address - Fax:302-733-0854
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:DEPT OF RADIATION ONCOLOGY
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-481-2800
Practice Address - Fax:215-481-6741
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2019-07-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS006905L2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0734790000OtherKEYTONE HEALTH PLAN EAST
PA232456156OtherDEVON
920006279OtherRAILROAD MEDICARE
PA1075488OtherKEYSTONE MERCY HEALTH PLA
PA001577008Medicaid
PA6857223OtherCIGNA
PA920006279OtherRAILROAD MEDICARE
PAPI0000531699OtherHIGHMARK BLUE SHIELD
PA0734790000OtherPERSONAL CHOICE
PA2512574OtherAETNA HEALTH PLAN
PAPI0000531699OtherHIGHMARK BLUE SHIELD
PA531699Medicare PIN