MEDICARE: OLIVIA GRACE HOFFSTADT MD, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	2026-02159	NC

General Provider Information

NPI Number	:	1689324352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA GRACE HOFFSTADT MD, MPH

Provider Business Mailing Address
First Line	:	6608 LYNFIELD DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-5813
Country	:	US
Telephone Number	:	817-733-5621
Fax Number	:

Provider Business Practice Location Address
First Line	:	1025 MOREHEAD MEDICAL DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-2963
Country	:	US
Telephone Number	:	704-446-7800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2022
Last Update Date	:	05/29/2026

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