Healthcare Provider Details

I. General information

NPI: 1407883564
Provider Name (Legal Business Name): ORLEEN A HOFFMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 02/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 VETERANS DRIVE ST. CLOUD VAMC
SAINT CLOUD MN
56303
US

IV. Provider business mailing address

1511 NORTHWAY DRIVE SUITE 101
ST. CLOUD MN
56303
US

V. Phone/Fax

Practice location:
  • Phone: 320-252-1670
  • Fax:
Mailing address:
  • Phone: 320-654-8266
  • Fax: 320-654-8481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number34842
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: