Provider Demographics
NPI:1992787261
Name:HOCHULI, STEPHAN URS (MD)
Entity type:Individual
Prefix:
First Name:STEPHAN
Middle Name:URS
Last Name:HOCHULI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 PROGRESS WAY STE 114
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6499
Mailing Address - Country:US
Mailing Address - Phone:410-549-9780
Mailing Address - Fax:410-549-9782
Practice Address - Street 1:1380 PROGRESS WAY STE 114
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6499
Practice Address - Country:US
Practice Address - Phone:410-549-9780
Practice Address - Fax:410-549-9782
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD39587208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD092591800Medicaid
E46354Medicare UPIN
MD092591800Medicaid