Provider Demographics
NPI:1720443393
Name:HOFBAUER, MEGAN POLANSKY (PA-C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:POLANSKY
Last Name:HOFBAUER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1741 DUAL HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6624
Mailing Address - Country:US
Mailing Address - Phone:301-790-0254
Mailing Address - Fax:
Practice Address - Street 1:1741 DUAL HWY
Practice Address - Street 2:SUITE A
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6624
Practice Address - Country:US
Practice Address - Phone:301-790-0254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-23
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0006020363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant