Healthcare Provider Details

I. General information

NPI: 1841528502
Provider Name (Legal Business Name): DUSTIN CARL HOFFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2009
Last Update Date: 09/26/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2716 ASHTON DR
WILMINGTON NC
28412-2489
US

IV. Provider business mailing address

2716 ASHTON DR
WILMINGTON NC
28412-2489
US

V. Phone/Fax

Practice location:
  • Phone: 910-332-3800
  • Fax:
Mailing address:
  • Phone: 910-332-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number75720
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number75720
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number202202175
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: