1639250889 NPI number — DR. LEE MARSHALL HOFFMAN DPM

Table of content: (NPI 1518835867)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639250889 NPI number — DR. LEE MARSHALL HOFFMAN DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOFFMAN
Provider First Name:
LEE
Provider Middle Name:
MARSHALL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639250889
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5755 W MAPLE RD
Provider Second Line Business Mailing Address:
STE 115
Provider Business Mailing Address City Name:
WEST BLOOMFIELD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48322-4415
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-626-7180
Provider Business Mailing Address Fax Number:
248-626-7175

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5755 W MAPLE RD
Provider Second Line Business Practice Location Address:
STE 115
Provider Business Practice Location Address City Name:
WEST BLOOMFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48322-4415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-626-7180
Provider Business Practice Location Address Fax Number:
248-626-7175
Provider Enumeration Date:
10/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  5901000829 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1308930 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 791480382 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 15990 . This is a "GREAT LAKES HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 50051 . This is a "OMNICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 574381 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0F37115002 . This is a "BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4426972 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 480F335300 . This is a "BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: LH000829 . This is a "BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0452330001 . This is a "ADMINASTAR DME" identifier . This identifiers is of the category "OTHER".
  • Identifier: 128831 . This is a "PREFERRED HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: DR630728 . This is a "PARTNER HEALTH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: T34416 . This is a "HEALTH ALLIANCE PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 27582 . This is a "OMNICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 3297999 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4426972 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 480024166 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: LH000829 . This is a "BLUE SHIELD FEDERAL EMPL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1002247-0003 . This is a "THE WELLNESS PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 128831 . This is a "CARE CHOICES" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com