Provider Demographics
NPI:1063703239
Name:HOBERMAN, MAURY (MD)
Entity type:Individual
Prefix:DR
First Name:MAURY
Middle Name:
Last Name:HOBERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 BRIDLE LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-2112
Mailing Address - Country:US
Mailing Address - Phone:610-692-2246
Mailing Address - Fax:
Practice Address - Street 1:931 BRIDLE LN
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-2112
Practice Address - Country:US
Practice Address - Phone:610-692-2246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027752L207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery