MEDICARE: LOUIS HOFFMAN MD PC

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	2084P0800X	Psychiatry Physician	4301019514	MI

General Provider Information

NPI Number	:	1700805983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUIS HOFFMAN MD PC

Provider Business Mailing Address
First Line	:	26711 WOODWARD AVE
Second Line	:	SUITE LL3
City	:	HUNTINGTON WOODS
State	:	MI
Zip	:	48070-1333
Country	:	US
Telephone Number	:	248-399-1434
Fax Number	:	248-399-1434

Provider Business Practice Location Address
First Line	:	26711 WOODWARD AVE
Second Line	:	SUITE LL3
City	:	HUNTINGTON WOODS
State	:	MI
Zip	:	48070-1333
Country	:	US
Telephone Number	:	248-399-1434
Fax Number	:	248-399-1434

Authorized Official
Title or Position	:	MANAGING AGENT-OWNER
Name	:	LOUIS HOFFMAN
Credential	:	MD
Telephone Number	:	248-399-1434

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	01/17/2008

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