Healthcare Provider Details

I. General information

NPI: 1760825483
Provider Name (Legal Business Name): ROBERT HOFFMAN THORWARTH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 10/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 N CHARLES ST
TOWSON MD
21204-6808
US

IV. Provider business mailing address

230 SCHILLING CIR STE 170
HUNT VALLEY MD
21031-1417
US

V. Phone/Fax

Practice location:
  • Phone: 410-296-4616
  • Fax: 410-337-5068
Mailing address:
  • Phone: 410-296-4616
  • Fax: 410-337-5068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD0082841
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberMTL001610
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: