Provider Demographics
NPI:1841356060
Name:HIEBLE, MARIA P (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:P
Last Name:HIEBLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:ALESSANDRA
Other - Last Name:PUGLIESE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:685 KNOX RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-2015
Mailing Address - Country:US
Mailing Address - Phone:215-476-3344
Mailing Address - Fax:610-688-4961
Practice Address - Street 1:940 W KING RD
Practice Address - Street 2:MALVERN INSTITUTE
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3166
Practice Address - Country:US
Practice Address - Phone:610-647-0330
Practice Address - Fax:610-644-6129
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016775E2084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPU31868OtherPENNA BLUE SHIELD
B33784Medicare UPIN