Healthcare Provider Details

I. General information

NPI: 1710982855
Provider Name (Legal Business Name): HENRIK A HOFGAARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N 7TH ST STE 101
CHAMBERSBURG PA
17201-1795
US

IV. Provider business mailing address

120 N 7TH ST STE 101
CHAMBERSBURG PA
17201-1795
US

V. Phone/Fax

Practice location:
  • Phone: 717-749-4801
  • Fax: 717-749-4852
Mailing address:
  • Phone: 717-749-4801
  • Fax: 717-749-4852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD424179
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: