Provider Demographics
NPI:1205958279
Name:VAN HOVE, COREY ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:ELIZABETH
Last Name:VAN HOVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:COREY
Other - Middle Name:ELIZABETH
Other - Last Name:MAGNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3201 19TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-1005
Mailing Address - Country:US
Mailing Address - Phone:212-928-1179
Mailing Address - Fax:
Practice Address - Street 1:3201 19TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-1005
Practice Address - Country:US
Practice Address - Phone:212-928-1179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD26908208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery