Provider Demographics
NPI:1104870229
Name:HOFFBERG, HOWARD J (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:J
Last Name:HOFFBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10085 RED RUN BLVD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4836
Mailing Address - Country:US
Mailing Address - Phone:410-363-7246
Mailing Address - Fax:410-356-5373
Practice Address - Street 1:10085 RED RUN BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4836
Practice Address - Country:US
Practice Address - Phone:410-363-7246
Practice Address - Fax:410-356-5373
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0030980174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
K552AA12Medicare ID - Type Unspecified
MDE23675Medicare UPIN