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Organization
HANOVER FAMILY PRACTICE ASSOCIATES, LLC
Active
Organization
HANOVER FAMILY PRACTICE ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE MOUL (PRACTICE ADMINISTRATOR)
(717) 632-0774
Entity
Organization
Contact information
Practice address
111 PENN ST, HANOVER, PA 17331-1929
(717) 632-4449
Mailing address
111 PENN ST, HANOVER, PA 17331-1929
(717) 632-4449
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02307000
BLUE CROSS
PA
01
—
0859603000
INDEPENDANCE BLUE CROSS
PA
05
—
1007518240013
—
PA
01
—
1520197
GATEWAY
PA
01
—
182943
HEALTH AMERICA/ ASSURANCE
PA
01
—
238893
MAMSI
PA
01
—
5337129
AETNA
PA
01
—
827916
BLUE SHIELD
PA
01
—
CC6198
PALMETTO
PA
Enumeration date
05/02/2006
Last updated
02/03/2009
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