Healthcare Provider Details

I. General information

NPI: 1265495949
Provider Name (Legal Business Name): HOOVER ADGER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N WOLFE ST #2065
BALTIMORE MD
21287-0005
US

IV. Provider business mailing address

PO BOX 64316
BALTIMORE MD
21264-4316
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-5710
  • Fax:
Mailing address:
  • Phone: 443-287-8944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD30921
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: