Provider Demographics
NPI:1366563876
Name:HOOVER, TODD ALAN (MD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:ALAN
Last Name:HOOVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:822 MONTGOMERY AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1948
Mailing Address - Country:US
Mailing Address - Phone:610-667-2138
Mailing Address - Fax:610-667-2139
Practice Address - Street 1:822 MONTGOMERY AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-1948
Practice Address - Country:US
Practice Address - Phone:610-667-2138
Practice Address - Fax:610-667-2139
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2010-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD035426E207Q00000X
CO43178207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF86213Medicare UPIN