Healthcare Provider Details

I. General information

NPI: 1144202367
Provider Name (Legal Business Name): PETER FREDERIC HOFFMAN M.D., PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34804 WILLIAMS GAP RD
ROUND HILL VA
20141-2214
US

IV. Provider business mailing address

34804 WILLIAMS GAP RD
ROUND HILL VA
20141-2214
US

V. Phone/Fax

Practice location:
  • Phone: 540-554-2335
  • Fax: 703-771-7471
Mailing address:
  • Phone: 540-554-2335
  • Fax: 703-771-7471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number0101020580
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: