Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 15167 | NV |
NPI | 1073639761 |
---|---|
Provider Name | Dr. Thomas Andrew Hovenic |
First Address | Reno, NV 89502-1464 |
Second Address | Reno, NV 89502-1464 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 03/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
HL758Z | (02) | NV |