Healthcare Provider Details

I. General information

NPI: 1053317404
Provider Name (Legal Business Name): KAREN L HOVER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 09/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 FRENCH ST STE 2
BANGOR ME
04401-5064
US

IV. Provider business mailing address

205 FRENCH ST STE 2
BANGOR ME
04401-5064
US

V. Phone/Fax

Practice location:
  • Phone: 207-942-2238
  • Fax: 207-942-1973
Mailing address:
  • Phone: 207-942-2238
  • Fax: 207-942-1973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number013884
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: