Organization Name: | HANOVER MEDICAL |
NPI Number: | 1063564698 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MITCHELL EMANUEL GRUPP (ADMINISTRATIVE DIRECTOR) |
Mailing Address: | 217 E Churchville Rd Bel Air |
State: | MD US |
Postal Code: | 210143825 |
Phone Number: | 4108384717 |
Fax Number: | 4108384917 |
NPI Enumeration Date: | 01/16/2007 |
NPI Last Update Date: | 01/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246ZE0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Specialist/Technologist, Other |
Taxonomy Specialization: | Electroneurodiagnostic |
Taxonomy Definition: |