Healthcare Provider Details

I. General information

NPI: 1548481203
Provider Name (Legal Business Name): ALISON JEANELLE HOFFMASTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 FREDERICK AVE
BALTIMORE MD
21229-3618
US

IV. Provider business mailing address

776 HOLLOW RD
ELLICOTT CITY MD
21043-4718
US

V. Phone/Fax

Practice location:
  • Phone: 410-233-1400
  • Fax:
Mailing address:
  • Phone: 410-750-2391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberC0002817
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA00634
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: