Healthcare Provider Details

I. General information

NPI: 1346224193
Provider Name (Legal Business Name): STEPHEN M HOFFMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 02/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27301 DEQUINDRE RD SUITE 314
MADISON HEIGHTS MI
48071-3473
US

IV. Provider business mailing address

27301 DEQUINDRE RD SUITE 314
MADISON HEIGHTS MI
48071-3473
US

V. Phone/Fax

Practice location:
  • Phone: 248-399-4400
  • Fax: 248-399-4840
Mailing address:
  • Phone: 248-399-4400
  • Fax: 248-399-4840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number5101005828
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: