Healthcare Provider Details

I. General information

NPI: 1407517626
Provider Name (Legal Business Name): MR. JAMES SCOT HOFMANN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 01/10/2022
Certification Date: 01/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 E BIG BEAVER RD
TROY MI
48083-1905
US

IV. Provider business mailing address

1225 E BIG BEAVER RD
TROY MI
48083-1905
US

V. Phone/Fax

Practice location:
  • Phone: 248-524-8801
  • Fax: 248-524-8850
Mailing address:
  • Phone: 248-524-8801
  • Fax: 248-524-8850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: