Provider Demographics
NPI:1003981200
Name:HOFFERT, DEBORAH S (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:S
Last Name:HOFFERT
Suffix:
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 4839
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4839
Mailing Address - Country:US
Mailing Address - Phone:207-945-4474
Mailing Address - Fax:207-941-5913
Practice Address - Street 1:700 MOUNT HOPE AVE STE 470
Practice Address - Street 2:EVERGREEN WOODS
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5660
Practice Address - Country:US
Practice Address - Phone:207-945-4474
Practice Address - Fax:207-941-5913
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013480207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME127740000Medicaid
MEMM5676Medicare PIN
ME127740000Medicaid