Provider Demographics
NPI:1639307754
Name:HOFFMEISTER- BECERRA, MONICA (MD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:HOFFMEISTER- BECERRA
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:PO BOX 8147
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-8147
Mailing Address - Country:US
Mailing Address - Phone:706-320-2773
Mailing Address - Fax:706-321-6863
Practice Address - Street 1:701 PRINCETON AVE SW
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1303
Practice Address - Country:US
Practice Address - Phone:205-783-7142
Practice Address - Fax:205-783-7113
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003788207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL141673Medicaid
GA003126553Medicaid
GA202I082012Medicare PIN