MEDICARE: STUART M. HOFFMAN M.D.

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	208600000X	Surgery Physician	9758	NV
2	208600000X	Surgery Physician	254284	NY
3	208600000X	Surgery Physician	47994	AZ
4	208600000X	Surgery Physician	129128	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619927407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STUART M. HOFFMAN M.D.

Provider Business Mailing Address
First Line	:	11160 VERISMO ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-3442
Country	:	US
Telephone Number	:	702-768-6881
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 CORNELIA ST
Second Line	:	SUITE 102
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-2317
Country	:	US
Telephone Number	:	518-561-6410
Fax Number	:

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	11/01/2016

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