Healthcare Provider Details

I. General information

NPI: 1861673501
Provider Name (Legal Business Name): MARA L HOVER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2007
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3807 N 7TH ST
PHOENIX AZ
85014-5005
US

IV. Provider business mailing address

3877 N 7TH ST STE 400
PHOENIX AZ
85014-5061
US

V. Phone/Fax

Practice location:
  • Phone: 602-258-6797
  • Fax: 602-248-8113
Mailing address:
  • Phone: 602-258-6797
  • Fax: 623-248-8113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4552
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: