Healthcare Provider Details

I. General information

NPI: 1083084487
Provider Name (Legal Business Name): CALLI CADIEU HOFFMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CALLI CADIEU CHOUINARD

II. Dates (important events)

Enumeration Date: 09/29/2015
Last Update Date: 10/20/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 N MCEWAN ST
CLARE MI
48617-1440
US

IV. Provider business mailing address

2366 SANDSTONE DR
MT PLEASANT MI
48858-1539
US

V. Phone/Fax

Practice location:
  • Phone: 989-802-5251
  • Fax:
Mailing address:
  • Phone: 715-923-4941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601007566
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: