Healthcare Provider Details

I. General information

NPI: 1225709603
Provider Name (Legal Business Name): MARY ELIZABETH HOJNOWSKI RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2021
Last Update Date: 09/24/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10210 LA PLATA RD
LA PLATA MD
20646
US

IV. Provider business mailing address

13632 BRANDON CT
NEWBURG MD
20664-2830
US

V. Phone/Fax

Practice location:
  • Phone: 301-392-3007
  • Fax: 301-392-3441
Mailing address:
  • Phone: 301-609-1050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDX4506
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: