Healthcare Provider Details

I. General information

NPI: 1417396375
Provider Name (Legal Business Name): RIVER BEND FAMILY MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 N PENNSYLVANIA AVE
HANCOCK MD
21750-1135
US

IV. Provider business mailing address

131 N PENNSYLVANIA AVE
HANCOCK MD
21750-1135
US

V. Phone/Fax

Practice location:
  • Phone: 301-678-7007
  • Fax: 301-678-7009
Mailing address:
  • Phone: 301-678-7007
  • Fax: 301-678-7009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0056048
License Number StateMD

VIII. Authorized Official

Name: HEATHER JOETTE HOOVER
Title or Position: PRACTICE MANAGER
Credential:
Phone: 301-678-7007