Healthcare Provider Details
I. General information
NPI: 1538109806
Provider Name (Legal Business Name): SUSAN COLLEEN HOFFMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 06/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1601 E 19TH AVE SUITE 5300
DENVER CO
80218
US
IV. Provider business mailing address
6437 S DUNKIRK CT
CENTENNIAL CO
80016-1219
US
V. Phone/Fax
- Phone: 303-839-7440
- Fax: 303-839-7210
- Phone: 303-690-6313
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 29281 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: