Provider Demographics
NPI:1083606396
Name:HOFFMAN, ALLEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:M
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:165 VANN ST NE STE A
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7249
Mailing Address - Country:US
Mailing Address - Phone:770-225-2333
Mailing Address - Fax:770-218-5636
Practice Address - Street 1:165 VANN ST NE STE A
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7249
Practice Address - Country:US
Practice Address - Phone:770-225-2333
Practice Address - Fax:770-218-5636
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA024822207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA320123OtherWELLCARE
GA000295666DMedicaid
GAP00155695OtherRAILROAD MEDICARE
GAP00155695OtherRAILROAD MEDICARE