Healthcare Provider Details

I. General information

NPI: 1023053055
Provider Name (Legal Business Name): MARC STUART HOFFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 STATE ST
PORTLAND ME
04101-3776
US

IV. Provider business mailing address

144 STATE ST
PORTLAND ME
04101-3776
US

V. Phone/Fax

Practice location:
  • Phone: 207-879-3265
  • Fax:
Mailing address:
  • Phone: 207-879-3265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number014962
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number014962
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: