Provider Demographics
NPI:1295736494
Name:HOFFMANN, STEPHEN A (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:HOFFMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8264
Mailing Address - Country:US
Mailing Address - Phone:508-620-6920
Mailing Address - Fax:508-620-6921
Practice Address - Street 1:61 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8264
Practice Address - Country:US
Practice Address - Phone:508-620-6920
Practice Address - Fax:508-620-6921
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51102207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ07198OtherBLUE CROSS
MA0403510OtherUNITED HEALTH CARE
MA3035638Medicaid
MA60701OtherHARVARD PILGRIM
MA051102OtherTUFTS
MA3165160OtherAETNA
MAJ07198Medicare ID - Type Unspecified
MAB74935Medicare UPIN