Healthcare Provider Details

I. General information

NPI: 1881526184
Provider Name (Legal Business Name): NOAH BENNETT OFFENBACHER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 W PATRICK ST
FREDERICK MD
21701-4855
US

IV. Provider business mailing address

319 W PATRICK ST
FREDERICK MD
21701-4855
US

V. Phone/Fax

Practice location:
  • Phone: 301-360-4349
  • Fax: 240-397-5845
Mailing address:
  • Phone: 301-360-4349
  • Fax: 240-397-5845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number34752
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: