Provider Demographics
NPI:1346224193
Name:HOFFMAN, STEPHEN M (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:27301 DEQUINDRE RD
Mailing Address - Street 2:SUITE 314
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-3473
Mailing Address - Country:US
Mailing Address - Phone:248-399-4400
Mailing Address - Fax:248-399-4840
Practice Address - Street 1:27301 DEQUINDRE RD
Practice Address - Street 2:SUITE 314
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-3473
Practice Address - Country:US
Practice Address - Phone:248-399-4400
Practice Address - Fax:248-399-4840
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101005828207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1346224193Medicaid
MA5633045OtherBCBS INDIVIDUAL
MI1000450003OtherRR MEDICARE
MI118173OtherCARE-PREFERRED CHOICES
MI700H217350OtherBLUE SHIELD
MIC6998OtherM'CARE
MIE26739OtherHAP
MI0M92440107Medicare PIN
MA5633045OtherBCBS INDIVIDUAL