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General NPI Number Information
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NPI Number | 1164437612
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Entity Type | Organization
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Legal Business Name | HANOVER ANESTHESIOLOGY AND PAIN MEDICINE, P.C.
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 250 FAME AVE SUITE 102
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City | HANOVER
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State | PA
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Zip | 17331-1587
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Country | US
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Telephone | 717-632-9955
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Fax | 717-632-9893
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Provider Business Mailing Address
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Address Line | 250 FAME AVE STE 110
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City | HANOVER
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State | PA
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Zip | 17331-1587
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Country | US
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Telephone | 717-632-9955
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Fax | 717-632-9893
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. SUSAN E. MUMMERT
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Credential |
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Telephone | 717-632-9955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State | PA
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