Individual
DR. KENNETH M HANOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
730 W MARKET ST, LIMA, OH 45801-4602
(419) 227-3361
Mailing address
PO BOX 710776, COLUMBUS, OH 43271-0776
(419) 228-1506
(419) 228-3352
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35083567
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000325541
ANTHEM
—
05
—
2500154
—
OH
01
—
P00084101
RAILROAD MEDICARE
—
Enumeration date
08/04/2006
Last updated
07/08/2007
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