Provider Demographics
NPI:1588633085
Name:HOFFMAN, WALTER D (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:D
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:192 PARK CLUB LANE SUITE 100
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-204-1101
Mailing Address - Fax:716-204-0914
Practice Address - Street 1:192 PARK CLUB LANE SUITE 100
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-204-1101
Practice Address - Fax:716-204-0914
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY095176207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDO1424Medicare UPIN