Provider Demographics
NPI:1174690846
Name:HOFFMEISTER, JANA MARIE SR (MD)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:MARIE
Last Name:HOFFMEISTER
Suffix:SR
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-777-7120
Mailing Address - Fax:843-777-7102
Practice Address - Street 1:715 S DOCTORS DR
Practice Address - Street 2:SUITE C
Practice Address - City:CHERAW
Practice Address - State:SC
Practice Address - Zip Code:29520-7113
Practice Address - Country:US
Practice Address - Phone:843-921-2080
Practice Address - Fax:843-537-6822
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC33288207RC0000X
NY140619207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01053965Medicaid
NY01053965Medicaid
NY01053965Medicaid