Provider Demographics
NPI:1992766794
Name:HOCHBERG, MARC CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:CRAIG
Last Name:HOCHBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-706-6474
Mailing Address - Fax:410-706-0231
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-706-6474
Practice Address - Fax:410-706-0231
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0017972207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD413561100Medicaid
WV2000119000Medicaid
MD324685-00OtherBLUE CROSS/BLUE SHIELD
MD324685-00OtherBLUE CROSS/BLUE SHIELD
MDAQ55Medicare PIN
MD110092879Medicare PIN