Provider Demographics
NPI:1407952252
Name:HOFER, CATHERINE MICHELE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:MICHELE
Last Name:HOFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 S MINNESOTA AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-4744
Mailing Address - Country:US
Mailing Address - Phone:605-339-3378
Mailing Address - Fax:605-339-0710
Practice Address - Street 1:2701 S MINNESOTA AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-4744
Practice Address - Country:US
Practice Address - Phone:605-339-3378
Practice Address - Fax:605-339-0710
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD3601208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6701870Medicaid
SD100662Medicare ID - Type Unspecified
SDF38544Medicare UPIN