| Main Line Ear, Nose & Throat, Pc | |
|
17 Industrial Blvd, Suite 102, Paoli, PA 19301-1607 | |
| (610) 647-3727 | |
| (610) 647-4969 |
| Full Name | Main Line Ear, Nose & Throat, Pc |
|---|---|
| Type | Facility |
| Speciality | Otolaryngology - Facial Plastic Surgery |
| Location | 17 Industrial Blvd, Paoli, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780830620 | NPI | - | NPPES |
| 102498645-0001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | (Pennsylvania) | Secondary |
| 207YS0123X | Otolaryngology - Facial Plastic Surgery | MD431700 (Pennsylvania) | Primary |
| Provider Name | Christopher R Hove |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1134230436 PECOS PAC ID: 0042308074 Enrollment ID: I20071108000565 |
| Provider Name | Joanne C Greene |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1073555702 PECOS PAC ID: 8527079219 Enrollment ID: I20090731000377 |
| Provider Name | Michael J Mccandless |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1497916936 PECOS PAC ID: 8628130846 Enrollment ID: I20150408001796 |
| Provider Name | Melani S Mcguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306295167 PECOS PAC ID: 9537426994 Enrollment ID: I20171121000102 |
| Mailing Address | Practice Location Address |
|---|---|
| Main Line Ear, Nose & Throat, Pc 17 Industrial Blvd, Suite 102, Paoli, PA 19301-1607 Ph: (610) 647-3727 | Main Line Ear, Nose & Throat, Pc 17 Industrial Blvd, Suite 102, Paoli, PA 19301-1607 Ph: (610) 647-3727 |