Provider Demographics
NPI:1750348637
Name:HOOVER, PAUL M (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:HOOVER
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:P.O. BOX 555
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012
Mailing Address - Country:US
Mailing Address - Phone:724-728-2077
Mailing Address - Fax:724-728-2113
Practice Address - Street 1:647 THIRD STREET
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009
Practice Address - Country:US
Practice Address - Phone:724-728-2077
Practice Address - Fax:724-728-2113
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-039454E2081P2900X
PAMD039454E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC29946Medicare UPIN