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NPI Code Detail

MEDICARE: GREGORY BERNARD HOVERSTEN DO

MEDICARE: GREGORY BERNARD HOVERSTEN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianDO1811NV

General Provider Information

NPI Number : 1801877790
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY BERNARD HOVERSTEN DO
Provider Business Mailing Address
First Line : 22 VIA VASARI
Second Line :
City : HENDERSON
State : NV
Zip : 89011-3661
Country : US
Telephone Number : 712-251-0542
Fax Number :
Provider Business Practice Location Address
First Line : 22 VIA VASARI
Second Line :
City : HENDERSON
State : NV
Zip : 89011-3661
Country : US
Telephone Number : 712-251-0542
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 11/05/2013

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