MEDICARE: STEWARD CRAIG HOFFMAN PAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	OA000263L	PA

General Provider Information

NPI Number	:	1235258831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEWARD CRAIG HOFFMAN PAC

Provider Business Mailing Address
First Line	:	100 S PARK ST
Second Line	:
City	:	MOUNT UNION
State	:	PA
Zip	:	17066-1361
Country	:	US
Telephone Number	:	814-542-8627
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 S PARK ST
Second Line	:
City	:	MOUNT UNION
State	:	PA
Zip	:	17066-1361
Country	:	US
Telephone Number	:	814-542-8627
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	07/08/2007

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