| 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  |