Provider Demographics
NPI:1881740116
Name:HOFFMAN, JAMES ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALAN
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4927 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-2626
Mailing Address - Country:US
Mailing Address - Phone:651-647-1624
Mailing Address - Fax:651-647-0349
Practice Address - Street 1:1875 WOODWINDS DR
Practice Address - Street 2:SUITE 204
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2298
Practice Address - Country:US
Practice Address - Phone:651-686-4548
Practice Address - Fax:651-501-5843
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN37142208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNE64967Medicare UPIN