Provider Demographics
NPI:1831586718
Name:WALTERHOEFER, MARY ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:WALTERHOEFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ELIZABETH
Other - Last Name:LASCHINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:810 BESTGATE RD STE 450
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3648
Mailing Address - Country:US
Mailing Address - Phone:104-384-3045
Mailing Address - Fax:104-384-3044
Practice Address - Street 1:810 BESTGATE RD STE 450
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3648
Practice Address - Country:US
Practice Address - Phone:410-384-3045
Practice Address - Fax:410-384-3044
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-19
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101266341207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology