Healthcare Provider Details

I. General information

NPI: 1295025963
Provider Name (Legal Business Name): SARAH C G HOFFMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 GANNETT DR
SOUTH PORTLAND ME
04106-6942
US

IV. Provider business mailing address

190 RIVERSIDE ST SUITE 6B
PORTLAND ME
04103-1073
US

V. Phone/Fax

Practice location:
  • Phone: 207-773-0040
  • Fax:
Mailing address:
  • Phone: 207-661-2000
  • Fax: 207-661-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License NumberDO2624
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO2624
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: