Healthcare Provider Details

I. General information

NPI: 1023484987
Provider Name (Legal Business Name): ROBERT DUFFELL-HOFFMAN MS RD LD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 08/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W MEETING ST SPRINGS MEMORIAL HOSPITAL-FOOD AND NUTRITION DEPARTMENT
LANCASTER SC
29720-2202
US

IV. Provider business mailing address

800 W MEETING ST SPRINGS MEMORIAL HOSPITAL-FOOD AND NUTRITION DEPARTMENT
LANCASTER SC
29720-2202
US

V. Phone/Fax

Practice location:
  • Phone: 803-313-3278
  • Fax: 803-286-1884
Mailing address:
  • Phone: 803-313-3278
  • Fax: 803-286-1884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number215
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: