Provider Demographics
NPI:1063640100
Name:HOFFMAN, BENJAMIN JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:JOSEPH
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:P4
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-2718
Mailing Address - Fax:
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:P4
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-2718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-28
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1084242085R0202X
CA134342085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology