Provider Demographics
NPI:1700838687
Name:HOFFMAN, TAMARA L (DO)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:L
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1599 SOMERSET AVENUE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:WINDBER
Mailing Address - State:PA
Mailing Address - Zip Code:15963-0000
Mailing Address - Country:US
Mailing Address - Phone:814-467-5600
Mailing Address - Fax:814-467-5605
Practice Address - Street 1:1599 SOMERSET AVENUE
Practice Address - Street 2:SUITE #1
Practice Address - City:WINDBER
Practice Address - State:PA
Practice Address - Zip Code:15963-0000
Practice Address - Country:US
Practice Address - Phone:814-467-5600
Practice Address - Fax:814-467-5605
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013065207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017853170002Medicaid
PA1017853170002Medicaid
I67959Medicare UPIN