Healthcare Provider Details

I. General information

NPI: 1518039189
Provider Name (Legal Business Name): SANDRA JO HOFFMANN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 03/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 BRADDOCK BLUFF DR UNIT 1672
HILTON HEAD ISLAND SC
29928-8015
US

IV. Provider business mailing address

PO BOX 6538
HILTON HEAD ISLAND SC
29938-6538
US

V. Phone/Fax

Practice location:
  • Phone: 843-384-5146
  • Fax:
Mailing address:
  • Phone: 843-384-5146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number22033
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: