Healthcare Provider Details

I. General information

NPI: 1063547479
Provider Name (Legal Business Name): AMY SUE HOVEST MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 W MARKET ST
LIMA OH
45801-4602
US

IV. Provider business mailing address

PO BOX 636930
CINCINNATI OH
45263-4259
US

V. Phone/Fax

Practice location:
  • Phone: 419-226-4310
  • Fax: 419-226-4315
Mailing address:
  • Phone: 513-981-5123
  • Fax: 513-981-5015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35087630
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.087630
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: