Provider Demographics
NPI:1093929416
Name:HOFFSTETTER, PAMELA SUE (RD, LD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:HOFFSTETTER
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 RIVER BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-6976
Mailing Address - Country:US
Mailing Address - Phone:912-507-2645
Mailing Address - Fax:912-344-4375
Practice Address - Street 1:59 RIVER BLUFF DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-6976
Practice Address - Country:US
Practice Address - Phone:912-507-2645
Practice Address - Fax:912-344-4375
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD002348133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered