Healthcare Provider Details

I. General information

NPI: 1487394011
Provider Name (Legal Business Name): MICHAEL DOMINIC HOFFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5649 WYNNEWOOD DR STE 203
LAURYS STATION PA
18059-1124
US

IV. Provider business mailing address

2100 MACK BLVD FL 4
ALLENTOWN PA
18103-5622
US

V. Phone/Fax

Practice location:
  • Phone: 610-261-1123
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD490549
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: