Healthcare Provider Details

I. General information

NPI: 1497785232
Provider Name (Legal Business Name): CRAIG C HOFMEISTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 04/19/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD NE
ATLANTA GA
30322
US

IV. Provider business mailing address

1365 CLIFTON RD NE RM 4082
ATLANTA GA
30322-1013
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-8580
  • Fax:
Mailing address:
  • Phone: 404-778-8580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number079400
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number079400
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: