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Individual

DR. TODD R HOVERMALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
215 W 19TH ST, ANDERSON, IN 46016-4204
(765) 649-7351
(765) 649-8666
Mailing address
PO BOX 2272, ANDERSON, IN 46018-2272
(765) 649-7351
(765) 649-8666

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000387
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100136360
IN
01
791480277
RAILROAD MEDICARE
IN
Enumeration date
09/09/2005
Last updated
10/14/2008
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