Provider Demographics
NPI:1780744839
Name:HOOVER, ROBERT JAMES (MD, MSL)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAMES
Last Name:HOOVER
Suffix:
Gender:M
Credentials:MD, MSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 DENNISTON ST APT 3
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4451
Mailing Address - Country:US
Mailing Address - Phone:614-403-3187
Mailing Address - Fax:
Practice Address - Street 1:419 DENNISTON ST APT 3
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4451
Practice Address - Country:US
Practice Address - Phone:614-403-3187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044884L207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015953920006Medicaid
HO0898106Medicare ID - Type Unspecified
PA0015953920006Medicaid