Healthcare Provider Details

I. General information

NPI: 1013082049
Provider Name (Legal Business Name): SHEILA M HOFERT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 EASTERN AVE
BALTIMORE MD
21224-2735
US

IV. Provider business mailing address

5200 EASTERN AVE STE 400
BALTIMORE MD
21224-2734
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-0100
  • Fax:
Mailing address:
  • Phone: 410-550-0963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0054528
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: