Provider Demographics
NPI:1093951634
Name:HOFFMAN, MARK ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALAN
Last Name:HOFFMAN
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 1:1515 LOCUST ST
Mailing Address - Street 2:UNIT #1000
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3726
Mailing Address - Country:US
Mailing Address - Phone:215-985-2729
Mailing Address - Fax:
Practice Address - Street 1:1515 LOCUST ST
Practice Address - Street 2:UNIT #1000
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3726
Practice Address - Country:US
Practice Address - Phone:215-985-2729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-04
Last Update Date:2009-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-044448L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery