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Individual

JEFFREY STOVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
476 S MAIN ST, ANDOVER, OH 44003-9602
(330) 841-4000
(330) 656-5901
Mailing address
5700 DARROW RD, SUITE 106, HUDSON, OH 44236-5021
(330) 656-5911
(330) 656-5901

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35065864
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000269018
ANTHEM
OH
01
000000269069
ANTHEM
OH
01
000000385522
ANTHEM
OH
01
001525638-0003
PENNSYLVANIA MEDICAID
OH
05
0960152
OH
01
N367365
WELLCARE
OH
Enumeration date
12/28/2005
Last updated
06/11/2008
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