Provider Demographics
NPI:1245276427
Name:HOFBAUER, PAUL GERARD (DPM)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:GERARD
Last Name:HOFBAUER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 FREEPORT RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215
Mailing Address - Country:US
Mailing Address - Phone:412-782-4040
Mailing Address - Fax:412-781-1292
Practice Address - Street 1:241 FREEPORT RD
Practice Address - Street 2:SUITE 3
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215
Practice Address - Country:US
Practice Address - Phone:412-782-4040
Practice Address - Fax:412-781-1292
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001385L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T28429Medicare UPIN
H090842Medicare ID - Type Unspecified