MEDICARE: CLARISSA MEI CHING HOFFMAN

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	390200000X	Student in an Organized Health Care Education/Training Program	4351055667	MI

General Provider Information

NPI Number	:	1881536746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARISSA MEI CHING HOFFMAN

Provider Business Mailing Address
First Line	:	1500 E MEDICAL CENTER DRIVE, SPC 5312
Second Line	:	TAUBMAN CENTER, 1ST FLOOR, ROOM 1903
City	:	ANN ARBOR
State	:	MI
Zip	:	48109-5312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 E MEDICAL CENTER DRIVE, SPC 5312
Second Line	:	TAUBMAN CENTER, 1ST FLOOR, ROOM 1903
City	:	ANN ARBOR
State	:	MI
Zip	:	48109-5312
Country	:	US
Telephone Number	:	734-736-9178
Fax Number	:

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

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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