Provider Demographics
NPI:1700805983
Name:LOUIS HOFFMAN MD PC
Entity Type:Organization
Organization Name:LOUIS HOFFMAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING AGENT-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-399-1434
Mailing Address - Street 1:26711 WOODWARD AVE
Mailing Address - Street 2:SUITE LL3
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1333
Mailing Address - Country:US
Mailing Address - Phone:248-399-1434
Mailing Address - Fax:248-399-1434
Practice Address - Street 1:26711 WOODWARD AVE
Practice Address - Street 2:SUITE LL3
Practice Address - City:HUNTINGTON WOODS
Practice Address - State:MI
Practice Address - Zip Code:48070-1333
Practice Address - Country:US
Practice Address - Phone:248-399-1434
Practice Address - Fax:248-399-1434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010195142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P18630Medicare PIN
MIF06173Medicare UPIN