Healthcare Provider Details

I. General information

NPI: 1174690846
Provider Name (Legal Business Name): JANA MARIE HOFFMEISTER SR. MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 10/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 S DOCTORS DR SUITE C
CHERAW SC
29520-7113
US

IV. Provider business mailing address

PO BOX 3239
FLORENCE SC
29502-3239
US

V. Phone/Fax

Practice location:
  • Phone: 843-921-2080
  • Fax: 843-537-6822
Mailing address:
  • Phone: 843-777-7120
  • Fax: 843-777-7102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number33288
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: