Healthcare Provider Details

I. General information

NPI: 1437385861
Provider Name (Legal Business Name): BRYCE ADAM HOFFMAN M.D., M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2009
Last Update Date: 08/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 6TH AVE EMERGENCY DEPARTMENT
DES MOINES IA
50314-2613
US

IV. Provider business mailing address

PO BOX 4925
DES MOINES IA
50305-4925
US

V. Phone/Fax

Practice location:
  • Phone: 515-247-3121
  • Fax:
Mailing address:
  • Phone: 515-247-3121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number39354
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: