Provider Demographics
NPI:1811126816
Name:HOFMANN, MARISA FERRERA (MD)
Entity type:Individual
Prefix:DR
First Name:MARISA
Middle Name:FERRERA
Last Name:HOFMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARISA
Other - Middle Name:HULIGANGA
Other - Last Name:FERRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11781 LEE JACKSON MEMORIAL HWY
Mailing Address - Street 2:SUITE 550
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-3309
Mailing Address - Country:US
Mailing Address - Phone:571-777-5157
Mailing Address - Fax:703-890-2650
Practice Address - Street 1:1925 GLENN MITCHELL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-0170
Practice Address - Country:US
Practice Address - Phone:571-777-5157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-11
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245186207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology