Healthcare Provider Details

I. General information

NPI: 1255480869
Provider Name (Legal Business Name): PETER C HOFFMAN P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 01/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9199 REISTERSTOWN RD SUITE 107B
OWINGS MILLS MD
21117-4520
US

IV. Provider business mailing address

9199 REISTERSTOWN RD SUITE 107B
OWINGS MILLS MD
21117-4520
US

V. Phone/Fax

Practice location:
  • Phone: 410-998-3993
  • Fax: 410-998-3995
Mailing address:
  • Phone: 410-998-3993
  • Fax: 410-998-3995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00624
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: