Healthcare Provider Details

I. General information

NPI: 1942310206
Provider Name (Legal Business Name): RICHARD S. HOFFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 10/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 GENERAL BOOTH BLVD
VIRGINIA BEACH VA
23454-5691
US

IV. Provider business mailing address

PO BOX 758963
BALTIMORE MD
21275-8963
US

V. Phone/Fax

Practice location:
  • Phone: 757-832-0623
  • Fax: 757-721-0984
Mailing address:
  • Phone: 804-968-5700
  • Fax: 804-217-7991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101042539
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: