Provider Demographics
NPI:1720047707
Name:HOFFMAN, MICHAEL LAURENCE (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LAURENCE
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24355 ZINFANDEL LN UNIT 305
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1891
Mailing Address - Country:US
Mailing Address - Phone:559-410-5487
Mailing Address - Fax:
Practice Address - Street 1:21444 CARMEAN WAY
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-4572
Practice Address - Country:US
Practice Address - Phone:302-855-1233
Practice Address - Fax:302-855-2135
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10163207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILI51376Medicare UPIN