=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942310206
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RICHARD S. HOFFMAN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2006
-----------------------------------------------------
Last Update Date | 10/14/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1605 GENERAL BOOTH BLVD
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23454-5691
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-832-0623
-----------------------------------------------------
Fax | 757-721-0984
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 758963
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21275-8963
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-968-5700
-----------------------------------------------------
Fax | 804-217-7991
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 0101042539
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------