Provider Demographics
NPI:1336164078
Name:HOFFERBERT, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:HOFFERBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 MCALISTER RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-4147
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:433 MCALISTER RD
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-4147
Practice Address - Country:US
Practice Address - Phone:980-212-6018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9800277208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1336164078Medicaid
NC891164XMedicaid
SCN00277Medicaid
NC2262196BMedicare PIN
NCG81135Medicare UPIN
NCNC5677BMedicare PIN
NC2262196Medicare PIN
NC2262196AMedicare PIN
NC1336164078Medicaid
NCNC5677DMedicare PIN